The Story of St. Joseph`s Hospital, Hamilton
Transcription
The Story of St. Joseph`s Hospital, Hamilton
t a e r G The Canadian Catholic Hospital History Project Documenting the legacy and contribution of the Congregations of Religious Women in Canada, their mission in health care, and the founding and operation of Catholic hospitals. e d n a Gr Projet de la Histoire des hôpitaux catholiques au Canada Retracer l'héritage et la contribution des congrégations de religieuses au Canada, leur mission en matière de soins de santéainsi que la fondation et l'exploitation des hôpitaux catholiques. To Serve with Honour The Story of St. Joseph’s Hospital, Hamilton 1890-1990 by Peggy Savage Source: Courtesy of archives of the Sisters of St. Joseph of Hamilton Copyright: © Sisters of St. Joseph of Hamilton Used with permission Digitized: October 2013 TO SERVE VVITH HONOUR THESTORY OF HOSPITAL, HAMITTON ST.JOSEPH'S 1890-1990 SAYAGE PEGGY DL]NDURN PRESS TORONTO & OXFORD 7990 Copyright @Sisters of StJoseph's of the Diocese of Harnilton All rights reserved. No part of this Publication may be reproduce4 stored in a rehieval system, or transmitted in any form or by arty means, elechonic, mechanicalaphotocoPlang, recording or otherwise (exept brief passage for purpces of review) without the prior permission of Dundurn PressLimited. Design and hoduction:Andy Tong Printing and Binding:Gagn6 Printing Ltd., Louiseville, Quebeq Canada The publisher wishes to a&nowledge the ongoing generous assistanceand zupport of The Canada Council The Book Publiehing Industry Development Programme of the Department of Communications, and The Ontario Arts Coqncil. Care has been taken to trace the ownership of copyright material used in the text (induding the illustrations). The author and publisher welcome any information mabling them to rectify any reference or sedit in su@uent editions. l. Kirk Hounrd, Publisher Canadian Cataloguing in Publication Data Savage,Peggy,1953To Serve with Honour : The Story of St. Joseph's Hospital, Flamilton, 189G1990 Indude index. ISBN 1-55002-069-2 1. St.Joseph'sHospital (Hamilton, Ont.) -History. RA9$.F45S231990 I. St. Jmeph's Hospital (Flamilton,Ont.). II. Title. 362.1'1'@773s2 C9G09337&X Dundurn PressLimited 2181Queen Sheet East, Suite 301 Toronto M4E 1E5 Canada Dundurn Distribution 73 Lime Walk, Headington, Oxford OX3 7AD England CONTENITS Foreword 6 Preface 7 Chapter One THE HEALING BEGINS 8 Chapter TWo THE STSTERS OF ST.IOSEPH 13 ChapterThree EVERY WARD A CHAPEL 18 Chapter Four A SOTJLAND A MIND 25 Chapter Five IUBILEE-ANEWHOSPITAL 35 ChapterSix PUBLIC APPEAL 45 Chapter Seven A PERIOD OF GRACE 57 Chapter Eight CHANGING OF THE GUARD 63 Chapter Nine COMING OF AGE Chapter Ten LEADING THE WAY Chapter Eleven THE NURSES REMEMBER Chapter TWelve THE VOLUNTEERS 11,9 Chapter Thirteen THE HEARTBEAT OF ST. IOSEPH'S 723 St. Joseph'sHospital Quarter Century Club 1,34 Members of the Lay Advisory Board and the Board of Tiustees 736 EmployeeListing, December,7989 138 St. joseph 155 Index "t56 Foreword r-, \*ourage, vision and caring are three great virtues that the Sistersof St. Josephof Hamilton have for more than a century brought and continue to bring - to their mission and work. ln thelast century theSisterscourageously offered care to those who had been passedby - the olphans, the poor and the immigrants. They helped them reach a level of human dignity that is the goal of all true Christian service.In the faceof personaldanger,aswhen cholera and typhus broke out, the Sistersunselfishlycontinued their work without thought of themselves.Their motto "It is an honour to serve the sick" was never forgotten. As the Hamilton area grew and society required more and better health care,the courage of the Sisterswas combined with visioru and in 1890they establishedSt. Joseph'sHospital. With the help of generationsof health professionalsand lay people, the Sistersfashioned it into a benchmark health care facility. To this day, that reputation is secure. The Sistersof St.Josephhave always cared for the whole person. They know well that sicknesstouches the soul as well as the body. Their pastoral care,directed toward kindness, sensitivity, and prayer, is well-renowned and greatly appreciated by all with whom they comein contact. Courage, vision and caring are qualities neededin today's Churchand in today'shealth care field. The example of the Sisters of St. joseph of Hamilton gives glory to God, is a credit to them, and a lesson for all of us. For this, we thank them. May Almighty God bless all those connected with St. Joseph'sHospital for their Christian fidelity in their work of healing. Yours sincerely, ) f .,' A a\ / / | /et-=.-t- Most ReverendA.F. Tonnos Bishop of Hamilton Most RmerendA. F. Tonnos,Bishop of Hamilton. Preface As ExecutiveDirector of St.Joseph'sHospital trom1979 to 1988,SisterJoanO'Sullivan often referred to the hospital as "the Sisters'family business."It startedsmall, grew in responseto thedemand for its servicesand overcamemany obstacles.But it continued to succeedbecause the standardsthe owners set were never compromised and their faith never wavered. The Sisters of St. ]oseph are the first to point out, that their family includes hundreds of lay men and women who helped them to push back the frontiers of health careand education in our community. Nevertheless/we are deeply indebted to the Sistersfor lighting the way. It has been a privilege to chronicle the accomplishmentsof the Sistersand I am glad thatHughGreenwood, director of public relations, asked me to undertake the assignment. DebbieLogel, fundraising campaign manager for St.joseph's Community Health Centre,has been a wonderful friend during the development of this book. The storiesby and about people who have beenassociatedwith St.]oseph'soverthe years are what really breathe life into the bricks and mortar of its buildings. In the early 1980s,Joan Paterson,who worked in the physiotherapy department for 30 years, began to interview many of those people.Her researchforms a significantpart of the hospital's archivesand provided much of the material that becamethe basis of this history. Miss Paterson'sguidance and generous assistancehave been invaluable. To my friend PeterBailey,an editor atThc TorontoStar,I owe enorrnousgratitude. On a completely volunteer basis, he faithfully edited and improved the content of the manuscript. My warmest thanks to Peterforbeing a demanding editor who delivers his criticism with such a marvellous senseof humour. Many namesof Sistersand lay staff will not be found in this history. It was a thanklesstask to sort out who would, and who would not, be mentioned. The decision was certainlv not based on merit alone. My editorial advisors - Sisters Joan C/Sullivan, Virginia Hanlon, Marina Flaherty and StephanieVincec - all agreedthat every individual who has worked to serve the patients of St. Joseph'sHospital for the last 100 years is deserving of credit. By way of consolation we offer one of the Sisters' guiding principles, a maxim which states"Desire that othersthinklittle of you and much of everyone else; be grieved that you should be esteemedbut happy that others be esteemed." Thanksare due to the patientswho participated by sharing their experiences at St. Joseph'sHospital. The late June Bomes candidly explained her struggle with kidney disMy ease.Mrs. Bomesdied December31,1989. sincere condolences to her husband Robert and their family. Many thanks to Peter Boyadjian for his expert handling of the businessof producing this book. Finally, my husband's love and support is an integral part of all my endeavours. His unfailing enthusiasmover this book sustained my spirits and my confidence.My deepestand most affectionatethanks to you, Bob. PeggySavage December,1989 Hamilton, Ontario Chapter One THE HEALING BEGINS Ot u cool Monday morning in Toronto on April 19,1,852,four women in identical dress - long black wool skirts, white linen headdress and black veils - bundled themselves off to the Toronto docks. Ice had cleared the harbour only two days before and they were anxious to board one of the first available steamerswhich could ferry them across[.ake Ontario to Hamilton. The women were Sistersof St.]oseph who were guided by their faith in God, a love of His people and a desire to serve where they were needed. The Bishop's representative in the Niagara region --Fathei Edward Gordon, Vicar4eneral - had made an urgent plea to them to establishanother branch of their order in Hamilton. They had no way of knowing they were about to change forever the course of education,health careand socialservicesin the community which so desperatelyneeded them. The eldet of the group was Sister Delphine Fontbonne, 39, accompanied by her friend Sister Martha Bunning, 28, Sister Aloysius Walker and SisterJosephMcDonnell - two noviceswho had enteredthe conventin Toronto. Standing on the ship's deck, with the cold lake wind snapping theirwool skirts into black balloons, the women caught glimpsesof a shoreline unblemished by industry, buildings or other tracesof civilization. Sister Delphine was accustomed to new horizons. Helping to establisha Hamiltonbase for the Sistersof St. joseph was her third assignmentsinceaniving in North Americafrom France,where she was born in 1813.She was the niece of Sister St. ]ohn Fonibonne (who refounded the order in 1808in Franceafter the French Revolution) and she fervently carried on the ordels traditions. SisterDelphine was 22 when she volunteered to go to St. Louis, Missouri, where she lived with six other Sisters in a cabin with a leaky roof. Her first job was to care for orphans and teachthe deaf. In 1850SisterDelphine moved to Philadelphia to take charge of an orphanage and a novitiate. A year later she was again transferred, by request from Toronto's Bishop de Charbonnel, to do more of the same work in Canada.As the value of the Sisters'work gained recognition, eachyear brought more peti tions for help. The fact that increasing numbers of young women were attracted to the convent helped makeit possiblefor the Sisters to carefor orphansand wagetheirwaragainst diseaseand illiteracy. Maria Bunning was born n 1824 in the parish of Husen, Hanover, in what is now West Germany. She emigrated with her parents,Wilzum and Ellen Bunning, to theUnited States,where they settled in the St. Louis area on the Mississippi River. When she was 24 she professedthe religious vows of povertp chastity and obedience and followed Sister Delphine to Toronto in 1851.Six months later the two were on their way again, when Father Gordon appealed for help in caring for Hamilton's orphaned children. Maria becameMother Martha, the first superior of the Hamilton Sisters,and was relentlessin her efforts to carefor the city's poor, to organize fund raising, to canvassfor food, clothing and fuel, and to establish homes for the elderly and schools. Father Edutard Gordon, Vicst-General of Hamiltotr. There was much hard and heart-breaking work aheadfor thebrave little group of women who arrived at the Hamilton dock that April evening over a century ago.FatherGord on, 61, the city's only priest, met them with his horse and buggy. He had offered his home rent-free to the Sisters but apologized that it wasn't quite ready for them. The Sisters'annalsnote that until their home was readp "Mrs. Tewkesbury placed rooms at their disposal and kind gesfures from the new community were extended by Mrs. Murray, Mrs. Norton, Mrs. Nelligan and Mrs. Devany." FatherGordon appreciatedfrom fi rst-hand experience many of the problems facing his parishioners. Born ir:l Drblin,Ireland, he was orphaned at an early age and raised by his uncle. Although baptized into the Church of Ireland, he converted to Catholicism in his early twenties and becamea priest. In 1846he took over St. Ma4/s parish and after trying to meet the needs of the increasing number of new Irish families he appealed to his bishop in Toronto for help. The Sistersof St. Joseph must have seemedHeaven-sent. Hamilton had been incorporated as a city only five years before the Sistersarrived. The streets were laid out in a rough grid, bordered by Emerald Street on the east,ParadiseRoad on the west, Aberdeen Avenue on the south and Burlington Bay and the marsh (Coote's Paradise) on the north. Nehemiah Ford, an Englishman and painter who lived on Catharine Street,was the city's sixth mayor. The Earl of Elgin wasGovernor4eneral of British North America. Pope Pius D( held office in Rome as leader of the Roman Catholic Church. Hamilton'spopulation of 10,000was employed in textiles, breweries, food-processing flour mills, tanneries, small foundries and carriage works. The city had its own newspaper, Thc pub HamiltonSprctatorandI ourtul ofCommerce, lished by Robert Smiley at an office on Court House Square at the corner of Main and Hughson Streets.Various editions included a daily and semiweekly, with a weekly issuefor country circulation. If Sister Delphine had picked up a newspaper from the previous Saturday, she would have read a story bursting with civic pride which said, in part: The weather which ten days ago was as wintry as possible, withupwards of a foot of snow on the ground, presents now every appearance of summer, and a corrunencementof businessfor the season.The snow has disappeared entirelp the frostis quite out of the ground, the streets are actually dusty, and the grass is beginning to grow. The ice in the bay is rap idly melting under the genial influence of old SoL and the steamers are ready for the summer campaign. In the city we notice preparations for building on every street, and in some places op erationsare fairly commenced. . . . The seasonwill induce the utmost energy, and from the number of buildings which we have already heard contracted for and projected, we feel confident that there will be employment for more mechanicsthan we have now at present. The Globe wlll be pleased to learn that the 'ambitious little city' has taken a fresh start, and that she calculates on being, very shortlp the first city in Upper Canada, in population and wealth, asshehasbeenfor years in enterprise. On Sunday, April 25,for the first time since theirarrival, the Sistersparticipated in lvlassat St. Mary's Church. The front door facednorth on what is now SheaffeStreet.In their annals the Sisters describe the church, which was built in 1838,as "an unpretentious wooden structure." Originally, it was hmted by a woodburning stove.Lanterns and candlesprovided lighting As promised, the Sisters' convent home at the corner of Cannon and lvlacNab Streets was ready for occupancy five days later. Satisfied that her charges would be well cared for in their new home, Sister Delphine returned to her work in Toronto. On February '1.856, 7, she died after losing a three-week battle with typhoid fever. She was 43. In 1857 a new convent, or Motherhouse, was built at204 Park Street North where the Sisterslived for 95 years.In'1,952,they moved into their presentMotherhouse off Highway 5. The former convent chapel and refectory are now ocorpied by St. Cyril and Methodius Slovak Roman Catholic Church and parish hall. The rest of the building has been demolished. The Sisters' original convent was close to thepeoplewho neededthemmost-theworking classesclustered in north-end neighbour- hoods. The more affluent citizens, whose opposition the Sisterswould encounter later, were comfortably nestled in the south-west under the escalpment. Following the tradition of their religious order, the Sistersimmediately undertook the care of society's outcasts.Two orphan grrls, Margaret Brennanand SarahMclnerny, were the first to benefit from their kindness.Visiting the city's sick, poor and elderly in their homes alsokept the Sistersbusy. In 1853,educationof the poor became their next goal. The Sisters opened a private school at the convent and started Christian doctrine classesat St. Mary's church. The classeswere well-attended, parents and guardians were happy and the priest referred to the Sistersas "angels." With re5rlar penny collections as their sole source of revenue/ the Sisterswere somehow managing to perform miraclesof providenceforthe growing number of poor and hungry children. But meeting the needsof so many took its toll. Pushedto exhaustion,theSistersrequested assistancefrom Toronto, and help arrived just in time to cope with a devastating epidemic. Waves of Europeanimmigrants seekingto improve their fortunes were arriving in North America by the thousands. The ships which transported them also carried the scourge of the nineteenthcentury - cholera.The disease struck in the hot, dry sununer of 1854.A headachesignalled its onset,followed by vomiting, violent crampsandsymptoms associatedwith dysentery - high fever and dehydration. In the final stages,the victim's skin shrivelled and turned black.Death often occurredwithin 36 hours. To inhibit the spread of the epidemic, newcomers who had contracted the disease were not permitted past the harbour. Taking pity on them, FatherGordon purchasedsheds behind the Great Western Railway depot on Stuart Street, where the Sisterscared for the sick and dy-r.g around the clock. Thesecrude, overcrowded shedsand the Sisters'kindness would be the only experience many new immigrantshad in thenew world. The disease left many more orphansin its wake, which further taxed the Sisters'energy and resources. The contemporary treatments for cholera patients were ineffective becausethe causeof the diseasewas not understood. One method, for example,prescribedthe ingestionof a brew of calomel (a purgative) mixed withhalf a pint of hot ginger tea laced with brandp followed by the drawing of blood. Another method of treatmentwas to replacethe drawn blood with intravenous injections of milk, while yet another recommended a mustard plaster over the stomachand bowels. For other ailments, people relied on the patent medicinesand curesof the day. In 1852, regular advertisementsappeared for such potions as Hutchings Vegetable Dyspepsia Bitters,"a family medicine used by physicians of high standing." At 50 centsper large bottle, itwasclaimedtobe of inestimablevalue,since it "worked like a charm on a host of ailments such as liver complaints,jaundice, heartburn, faintness,and for females who suffer from a morbid and unnatural condition." An advertisement for Radway's Ready Relief also stated: "Science,by subjecting the laws of chemistry to the skill of man, has contributed to his health and happiness by stopping the most cruel and severepangs of pain in an instant and curing the most obstinate and chronic complaints." Radway and l0 Co., practical chemists,touted a product with such properties that anyone suffering from a host of agonies ranging from rheumatism, lumbago and cholera morbus to dysentery, heartburn and neuralgia, would find relief within 15minutes. At 25 centsper bottle, it was available at two shops in Hamilton and one in Dundas. Radway also made a medicatedsoap that "fastens hair upon the scalp and forcesit to grow and imparts beauty to the skin. " Mrs. Lewis of Ancasterwas the solerunufacturer of a homemade cough remedy. Her advertisement was complete with endorsements from satisfied customers.And Judson's chemical extract of cherryand lungwort was a cure-all for coughs,colds, hoarseness,spitting of blood, night sweats, asthma, liver complaints and consumption. The Buffalo Cold Spring Water Cure was offered in a "new and commodious building in a pleasant location" in Buffalo, New York, for patients seekingrelief through cold baths.The rationale for the treatment was to improve the blood by restoring the body's nervous fluids or electricity, which were reduced when the gastricjuiceswere unable to dissolve food. The baths were supposed to provide relief from ailments such as rheumatism and gout, aswell as to treat liver infections and dyspepsia now corunonly known as indigestion. The patients had to b.iog their own linen with them, aswell as half a dozen towels, otherwise an extra 50 cents per week would be charged. In 1852, doctors in Hamilton advertised theirservicesand areasof specialty.A Dr. Ross "respectfully announced to the inhabitants of Hamilton . . . that he had made himself thoroughly acquainted with the German method of practice by which he arrives at a correct diagnosisinallcases. . . he examinestheurine to tell the disease.. . . Medicines principally vegetable." A.N. Woolverton, M.D., referred to himself asa Homeopathistand Hydropathist who, after receiving a description of the disease, would forward medicine and advice to the patient by letter. His office was onJamesStreet "next door below Knox's Church." Surgeon Dentist J.L. Swift of Drblin and London, announced the opening of his office on King Street "nearly opposite Montreal Bank" This was the stateof medical sciencein the mid-l800s.Bythe end of thecenturytheSisters would play an official part in the community's health care by opening their own hospital. They would also witness many medical advancesand developments. As is often the case,people who are destined to play an important role in a given event are the most steadfastand unassuming.Sister Philip Lenater! 26,hadcome to Hamilton to help care for the orphans. Originally from County Wexford in Ireland, her speech still lilted with the music of an Irish accent.Working with her in thosedreary, drafty shedswas another Irish girl, Annie Sheridan, who had taken the name SisterMa.y Philomene when shemade her religious vows. Shewas 17 years old. Eachday the two Sisterswould maketheir way through the dusty streets,bringing supplies, comfort and cheer to the sick in their homes. One summer day in 1854,a nun and his wife called on SisterPhilip to say they had not seen their neighbours, an elderly couple, around their home in days. She and another Sisterbroke the door down to the neighbour's home. Inside, they found the people tn bed, both dead of cholera. Iater that day coffins were dumped off some distance from the home, becauseno one wanted to be near the foul stench of the dwelling. Undaunted, the Sisters wrestled the coffins inside and pre' pared the couple for a dignified burial. The streetswere empty because,mistakenlp people thought that if they did not go out they lessenedtheir chancesof getting sick. At that time people did not know that the crowded conditions in which they lived - along with a lack of garbage removal and proper drainage createdcesspoolsthat played hospitable host to the disease. In the quiet of that broiling hot day, the Sisters waited a long time before two black men arrived with a cart pulled by a bony old nag. With help from the men, the Sisters managed to heave the coffins onto the cart. Many years later, when asked if she was ever afraid, Sister Philip answered, 'nVe were too busy to have fear." The following year/ in 1855,typhus struck claiming Sister Alphonsus Margerum as a victim. Undeterred, the Sisters focused their skill and energy on the sick and dyiog. Thirtyfive years before they officially opened St. joseph's Hospital, the Sisterswere inextricably involved with health care. The decadesbefore the hospital opened, however, were not spent idly. On the first Monday inSeptemberof1856,they openedSt. Mary's school on what is now MacNab Street and the first St. PatricKs school on the corner of Ferguson and Hunter Streets.Today there are just over 60 separateelementaryand high rhools in Hamilton, Winona, Binbrook, Ancaster,Dundas,StoneyCreekandWaterdown. They are administered by the Hamiltonll Wentworth SeparateSchoolBoard - located, appropriately enough,onMulberryStreet, half a block from where the Sistersfirst lived and worked in 1852. On February 17,1856,Hamilton became the centre of a new diocese.The first bishop was Rt. Rev. |ohn Farrell. From this time the Sisters living in Hamilton separated from Toronto and had their own Motherhouse and novitiate. In their leisure time the Sisterswere welcome to wander on the pleasant landscaped grounds of Sir Allan MacNab's estate,Drndurn Castle.For a brief period they held classes there for the education of poor children in the city's west end. Winter was especiallyrigourous when they had to slog through snowdrifts in the walkfrom the convent and then teachin damp, heavy clothing all day. MacNab's daughter, Sophia,was keenly interestedin the Sisters' work and was a generouscontributor to their various causes.She donated to the convent one of Dundurn Castle'sbells, which was rung daily in thebelfry to announcereligious exercises.It gave Sophiaspecialpleasure to hear it ring, because it reminded her of happy times at Dundurn. As theSisters'charitableworks grew, their courageand constancywere alsorewardedby increasedsupport from the averagecitizen. In 1858,the Sistersdecided that the daily walk from the convent on ParkStreet to St.Patrick's school was too long. They felt that if some of them moved closerthey would alsohave more time to visit the poor and sick in what was then the eastend of the city. Much to the Sisters'surprise, a total stranger leasedto them a house which had been vacant for years.Rent was set at $1 per year. Shortly after moving, a neighbour askedif the Sisterscould hear "great, strangenoisesat night." The Sisterssaid yes,but thought it was from a nearby stable."No," replied the neighbour, "your houseis haunted."Aft er theBishop blessed the house from garret to cellar the noisesstopped.Unfortunatelp haunted or noL thehouse had to beabandonedtwo yearslater becausethe Sisterswere unable to meet the expenses of maintaining an additional residence. By 1859, seven Sisters and nine novices sharedthe workload of teachingin the schools and caring for 53 orphans. Along with financial hardship, they also encountered other problems. On August 30 of that year a fire de' stroyed their beloved St. Ma4/s Church. No one was killed and the sacred vessels,along with the BlessedSacrament,were saved. But other valued church furnishings - vestments, oil paintings, the Bishop's throne and a coloured stahre of the BlessedVirgin Mary were lost to the blaze.SisterVincent CIHagan, 26, the church sacristan,attempted to salvage them in vain. Whenever their fortunes threatened to ebb, an appreciative community always rallied to thechurctr's aid. FrederickKortum, a Germanborn architect, designed a new Gothic-style church. It was built between 1859and 1850on the site of the ruins by volunteer labour provided by parishioners.St. Mary's becamethe seatof the Bishop of Hamilton until 1927.Itis still a parish church. Local farmers donated wood to warm the convent during the bitter winter months. They also provided horseand buggy transportation when the Sisters made their regular visits to the countryside to collect money for the orphanage. Thecollectionswere alwayssuccessfuI and, on occasion, humoutous. br one instance, a Sisterwas welcomed into the home of a Protestant woman. Looking at the Sister's habit, which had been modelled on widow's dress with the addition of a veil and guimpe, the woman asked the Sister in all sincerity, if she had a headacheand, how long had her husband been dead? After the Sister explained who she was and what she did, she received the woman's generous,lifelong support. Members of the medical profession, too, were staunchadvocatesof the Sisters'endeavours and publicly encouraged support. In '1.864, Dr. Martin J. O'Dea, medical February, attendant at St. Mary's orphanage,reminded readersof TheHamilton EaeningTimesthat the time was drawing near to contribute to the olphanage, "orte of the oldest and most de. serving charities in the city." In a summary of how the alms were used, he revealed that increasedaccommodationwas neededfor the growing number of homelesschildren and de' rribed the institution as "a safe,seflrre refuge for girls." He added, "it is sanitary and children who arrive suffering from scrofula (swelling of the lymph glands of the neck due to poor ventilation and malnutrition) are always restored to health by the Sisters." Revenuescraped together through donations, fund-raising festivals, bequestsand collections allowed the Sisters of St. joseph to advance their combined cause of education and care of the sick, homelessand elderly. Along with their own fmgal, communal living, these contributions ensured the ful- t2 fillment of one of their maxims, which states: "Shrdy to exhibit kindness to all, and unkindnessto none." By 1867,the Sistersof St. ]oseph were in a position to help the Sisters of Loretto when that teaching order arrived in the city. The Loretto order had purchasedMr. JohnO. Hatt's residence on King Street, between Ray and Pearl Streets,in order to establisha boarding school. Drring the month it was being pre' pared, they received the gracious hospitality of the Sistersof St. Joseph,who were elatedat the growth of separateschool education. The needfor expandedhealthcareservices continued to gain recognition. In 1882,Father ]eremiah Ryan from St. Andrera/s Parish in Oakville left a bequest in his will, the interest on which was to be given for the support of the poor patients in a ward of the hospital when it was erected.The following year anotherbenefactor, a Mr. Duffy,left a bequestin his will for the building of a new hospital. Sevenyearswould passbeforetheirmoney was used for its intended purpose. It was not until 1889that the Sistersof St.Josephundertook plans for their hospital under the capable direction of Sister Philip Lenaten, who had honed her nursing skills during the city's cholera and typhus epidemics. Initially, the hospital's opening was not greeted with enthusiasm by everyone in the community. The Sisters would have some obstaclesto overcome which they viewed as yet another stage in a continuing processof facing difficulties with perserverance, determination and absolute faith in the purpose of their mission. Chapter Two THE SISTERS OF ST.IOSEPH "Thisgroupwill becallcdtheCongregation of St. Ioseph,a cherishednatnewhich will remindthe Sistersto assistand serpetheir dearneighbourwith tlu samecare,looing attention,charity and corilialitythnt the gloriousSaintJosephlwd in snoingtheHoly Virgrn,hismostpure spouse, andtheSaaiour, lesus,hisfosterson." - Father JeanPierre Medaille, S. j. The tradition of dedication and service that St. ]oseph's Hospital celebrateson its 100th anniversaryis, in fact,overthreecenturiesold. It is a tradition passedon like a torch from one generation of gentle women to the next. This flame was lit in France,where the Congregation of the Sisters of St. |oseph originated in 1650. Although threatened by resistance, oppression and revolution, it has never been extinguished. The spiritual director of the Congregation of the Sistersof St. joseph was a saintly missionary,JeanPierreMedaille, a jesuit priest (of the Society of Jesus),who recognized a religious dedication to prayer and service in a number of women who sought his guidance. He drew up what he called "a little design" for their institutioru a spiritual way of life that allowed them to serve all types of people through any suitable activity which a wonvrn could do. Reonend Mother St.f ohn Eontbonne,7759- 7843 13 hr their original constitution, Father Medaille touched on and guided every aspectof the Sisters'lives - from how and where they would live to codesof behaviourand religious exercises.Above all, the plan bade women to perform pious works of mercy: Each day they shall visit the sick poor. . . . From time to time they will visit prisons.Let them procure spirihral and temporal assistancefor the imprisoned, according to their ability. Let them prepare broth and other things prescribedby the physician in the treatment of the sick . . . their careand concernshould be thesameasthey would show to the sacred person of Jesus Christ. They will furnish a room with thesupplies necessaryfor tending to the poor, and keep a sort of pharmacy with a variety of drugs and medicinesfor the sick. They will dispense these remediesprudently and under the docto/s prescription when necessary... . Among otherthings,they will be watchful in providing for young girls who are in danger of losing their virtue because they have no one to help or direct them, or because thev are in need of money. The Sisters will try to find a home and work for such girls. . . . The residence of the Sisters will ordinarily be an apartment in a hospital or orphanage.. . . Aft er their novitiate, they will make three simple vows of poverty, chastity, and obedie n c e .. . They are to live in perfect interior peace,moderation,and exterior modesty, virtues founded on a generousmortificationof all their passions,petty whims, and any inclinations thatare evenslightlyvicious or repugnant to grace. FatherMedaille's highcalling with its stringent standards welcomed women from three defined social categories.The first, he said, willbe womenwho havesufficientincomefor their own support and who can devote themselves completely to worla of charity. The secondconsistedof women who would com- The firct rcception ol the Sisterc of St.loseph on October 15,7650in I* Puy, France. t4 pensate for their lack of temporal goods by earnestlabour. Finally, widows and women of the poorer class would be accepted if they agreedto "work more diligently and live more fntgally." Eventuallp the class distinctions within the sisterhood disappeared.Their special gift was to promote unity among all people and with God. At first, becausethe seventeenth-cenfury Church in Francewas suspiciousof any religious women not living in a cloister,the association was a secret one. However, Henri de Maupas, Bishop of Le Pup was one man with an open attitude. Father Medaille presented the Bishop with his simple yet comprehensive plan, which placed the Sistersunder the protective care of St. Josephbut did not require that they lead cloistered lives. Rather they were called to imitate Christ's life on earth by going out among the people to devote their efforts to the work He cherished- to aid the sick, visit the poor and teach the children. As individuals, they were expectedto have humility and reflect a passionatelove of God. This was called the "active and contemplative life." Medaille's design also erectedthe framework for a rich and enduring spiritual tradition with "100 Maxims of Perfection," fundamental principles to which the Sisters still adhere. Theseare a collection of exhortations basedon gospelvalueswhich areshort enough to be memorized and which essentiallysummarize the Sisters'philosophy The Bishop's approval was complete. He gave official existenceto Les Filles de St. Joseph by accepting the vows of the first six members on October 15, 1650, and putting themin chargeofa houseof refugefororphans and women left destituteby the wars in France. Many of theseearly Sisterscould neither read nor write. To support their endeavours they made and sold lace. In order to safely pass through the streets to visit the sick and the Poor, they wore the black outfits common to rnany widows of the city, which Father Medaille had suggestedas suitable attire: Their habit will be modelled on the dressof widows with a veil covering the upper face a black taffeta cap, and a linen band to the middle of the forehead, a white coif under the black and a plain kerchief drawn quite closeto the neck. After profession, a brass crucifix attached to a black wooden crosswill be worn soasto hangon thebreast. A rosary of fivedecadeswillbe attachedto the cincture.Alt wil be appropriately poor, simple and modest. 1n7674,King Louis XIV granted civil recognition to the congregation,which had rap idly flourished all over the country. A century later, however, all the foundations crumbled under a deluge of blood and terror during the French Revolution of 7789. Convents were closedand properties confiscated,forcing the Sistersto seek refuge in the homes of their relatives.In the town of Bas,Sistersescapedto a cave,carrying the BlessedSacramentin order to preserve it from desecration. Drring the Reign of Terror, those suspected of being againstthe Revolution or who refused to prononncean oath of allegianceto the Revolutionary state (demanded by the government but she was spared meant that the congregation could survive and grow. With their convents destroyed,the Sistersleft prison and rehrrned to live with their families. In 1802 at the requestof Napoleon'suncle, the Bishop of Lyon, SisterSt. john established a novitiate to receive a new generation of women who were interestedin non-cloistered religiow life. As JeanneFontbonne she had entered the congregationin 1778at the age of 19 and in the course of her religious life had already run a school and a hospital. With her experienceand leadership skills she was the Flight utith tle BlessedSactamefltdudng the French Reoolution. forbidden by the Pope)were often guillotined. One nury Sister St. John Fontbonne, had returned to her familybut elevenmonths later was imprisoned and sentencedto death with other Sistersat St.Didier. In what they thought were their final hours on earth, the Sisters happily prepared for death and even bribed the jailer to procure some clean white linen so that they might appear presentable to meet their Lord. The night before their executionRobespierre,the most infamous of the revolutionaries, was himself imprisoned and prisonersall over Francewere set free. When the revolutionary government fell from power on July 27,1794, its decrees were nullified, including Sister St. ]ohn's execution order. Future generations of her order said that although martyrdom escapedSister St. Johru she sought no escapefrom martyrdom. She A Sistn of St,loseph pays the supremesarifice by rvas prepared to die for her faith. The fact that dying f or her faith iluittg the French Reuolution, t5 uOnercasonlchosetoilepictthe Sisterc'formerhabitisbecauseof its soft,classiclines. It makcs e timcless staternent. Theseimages are a celebratiott of the Sistersat worh They'rc fiecflt to be soft, to cotmey the Sistetsas looing and caingutomen," Theseillusttations demons*ate the Sisters' oiginal an* in Hamilton - caring otphaned chililret end the eliletly. for For self-teught Hamiltott afiist Gitto Ccoicchioli, the Sistets of St. loseph twioe happy nemoties of Sistets he kneut cs sn altar boy in Rome. "The story of the Sisters' ileilicction ifuing thc chobre anil typhus ryiilemics in Hamiltoa in the 7850sooer uhclmeil me becat* they had only their teligious beliefs for protection," he seid. Inhispencilihewitgs, Gino,whouto*sfulltime as eDofascoVipefittel seyshis aim is to cspturc a ftesh ,nornerrtthat shouts the Sistersin a positioe, inspiing uay. l6 ideal candidate to found a new Motherhouse at Lyon which attracted former members and novices alike. It is in SisterSt. John's memory and honour that the name Fontbonne is so often used to dedicate significant buildings (such as a librarp nursing school or auditorium) built by the Sisters. With the orde/s refounding the widow's cap and shoulder kerchief were replaced by the veil and a large white bib called a guimpe, the habit worn well into the 1960sand which can still be seen today on a few of the older Sisters.More recently, after Vatican tr in 1965, when Rome called for renewal in all religious groups, causing the Sistersof St. ]oseph to reexamine their mission, ministry, lifestyle and constitutions, the Sisters also reviewed their habit. Initially, the inconspicuous dress of bereaved women allowed the Sisters to mingle unnoticed among the people. They found that the change to modest everyday streetwear would grant that same freedom in modern society.Although lay people can still be found who prefer the Siste/s black habit, the fact is, she was never meant to be identified by her mode of dress. Through the centuries the Sisters of St. Joseph have responded to every need they were capable of firlfilling, whether it was the care of orphans and the elderly, education or health care.V/herever they worked the world over, they laid the groundwork for lay professionals to take over in schools and hospitals. Eventually, foster care replaced their orphanages and in 1973 community colleges took over their nursing schools. Today there are 25,000Sistersof St.joseph working in Central and South America, North America, Europe, Africa and Asia. Fewer geographicalfrontiers may beckon for their help than in the 1850s.In some societies social assistance,universal education and goverrrment health insurance have replaced the need for the Sisters'efforts in theseareas. But, unfortunately, our sophisticated society has ushered in a whole new set of problems. These are the people who live in society's wasteland, devoid of spiritual and emotional support. They may alsosuffer racial prejudice or economichardship. The Sistersof St.Joseph feel called by their original mission to promote peace,unity, healing and reconciliationamong such people.This is why, in the 1990s,they can be found working in the pastoral service department of a hospital, in parish ministry or as high school chaplains. They also administer soup kitchens, food banks, detoxification centres,homes for girls and women, and diocesancentresof spiritual renewal. In St. Joseph'sHospital in Hamilton, the Sisters'continued presenceis felt throughout the building, notably in the Pastoral Service departrnent and on the Board of Trustees.As Father Medaille suggestedover three centuries ago, they live in small groups: in the hospital, in transition homesfor women, in inde pendent dwellings and at the Motherhouse. The city benefitsasmuch today asit did in 1852 from the Sisters'many charitableworks. During the influx of refugees in the late 1980s, rooms were renovated at Mount St. Joseph,a former orphanageon King StreetWestto house refugee families. The families then received assistancein locating a perrnanent home. As theresult of a study,a programisnowin place t7 to assistbereavedfamilies in the diocese.And, after yearsof planning the Sisterswill enter the next century offering health care services to the growing population in the region's east end through a new ambulatory care centre. Much of what is accomplished is done with the help of lay people,bringing to life one of theCongregation'smaxims: "Advance good worksuntil near theircompletion and then,if it can be done unobservedly, let others perfect them and gain all the credit." It is this philosophy that allows the Sisters to detach themselvesfrom one project in order to meet and embracenew challenges. Chapter Three EVERYWARD A CHAPEL T'l Dy '1889,the Sisters of St. joseph were sufficiently encouragedby doctors and some citizens to continue their work in health care in a more formal way by opening a hospital of their own. Before it could be accomplished, however, they had to listen to vigourous, ill-informed arguments against it. Where taxes were concerned,an old bias prevailed: that the Roman Catholic element would createa division in the community. Of the city's 49,000inhabitants at the time, 7.5per cent were affiliated with Jewish and other religions while a full 75 per cent were either Anglican, Baptist, Lutheran, Presbyterian or Methodist. This majority felt threatenedby the 17.5 per cent of the population who were Roman Catholic. In 1890,Hamilton was the fourth-largest city in Canada. Restrictedby the bay and the mountain, the city had expanded eastward to its new limit at Sherman Avenue. The Che doke ravine represented the western border. Electrified streetcars on 10 miles of double track replacedhorse-or mule-drawn cars.The east-westlimits were linked by a route along Main Street. A second one on James Street bridged the gap from the downtown core to the bayfront. To join the city with the escarpment, an incline railway was perched on a 45degree angle at the head of jarvis Street.By the turn of the century there would be another at the head of Wentworth Street.New enterprise thrived The altar of the hospital chapelin7922. t8 in the "ambitious city." Traditional industries producing consumer goods had been joined by large, more specializedenterprisessuch as the Ontario Rolling Mills, an employer of 500, which would eventuallyjointheCanadaScrew Company and the Ontario Tack Company to form the Steel Company of Canada. Sanford Manufacturing Companp the country's largestclothing establishmentwith 3,000employees,waslocatedonthecornerof Kingandlohn Streets.With the harbour and the GreatWestern Railway, shipping and transportationlinks to points outside the city were well established. The city was orderly and organized,boasting service such as a police force, water sup plp street lighting and sewers.Opulent landmarks - both private and commercial - includedWhitehern,a GeorgianhouseonJackson Street where foundryman Calvin McQuesten lived; Inglewood, a Gothic revival mansion built below the escarpmentby GeorgeHamilton; Sandyford Place,an Italianate stone terrace of row housing built by Scottishmasons; the classic revival Central Public School on Hunter Street, Gothic St. Paul's Church on JamesStreet and, Sir Allan Napier MacNab's baronialDrndurnCastleatthe westernend of the bay. Yet with all thesesymbols of progressand a healthy economy,resistanceto the establishment of a new hospital to serve the ever-increasingpopulation was rigid. The most fierce opposition was registeredby those who lived in the comfortablesouthwest neighbourhood, its proposed location.As one Sisterexplained, "Hospitals in thosedays, like cemeteries,were not welcome in urban living areas.They were neededin the sameway that transition homes are needed todap for example. It's human nafure not to want these institutions in one's midst." The Sisters had no trouble in finding a suitable building for their hospital. Bishop Thomas joseph Dowling, then 50, had been transferred from Peterborough in May, 1889, to becomeBishop of the dioceseof Hamilton. He was to have lived in Undermount, a residenceon John StreetSouth, between the present St. Joseph'sDrive and Charlton Avenue. Bishop Dowling found the mansion too large, too expensiveto maintain and too far from his parish at St. Mar;/s on SheaffeStreet.On July \9,'1,889, he sold it for $10,000to the Sisters.In later years,Undermount was simply referred to as "the 1890buildingl' at the hospital. But the neighbourhood was in a dispute over whether it was an appropriate location for a hospital at all. In a story on September9, "1.889,Thc Hamilton Spectatoraird, the objections.Residents expressedconcernthat a hospital in their midst would hurt the area'scharacter,make it unde- Bishop Thomas f oseph Dotoling fourth Bishop of Hamilton. Bishop Douling's residetce,Undermount,openedes St.f oseph'sHospital on fune 77,7890.TheUndermount name continued as part of the Sistus' trailition uhen Uniletmount Nurses'School opeteil in 7922arul the Undermount yeatbook was publisheil in 7934. 19 sirable and drive down property value. They hospital there, as the Roman Catholic authorifearedthe spreadof an epidemic or contagious ties own the property, unless they should ask diseasessuch as diphtheria. Germs and bacte- some grants from the citp which is hardly ria were still the unseen enemy. It was still likelp as they are a rich colporation." In addiconsidered much safer, in the publiCs mind, to tion, the story continued, the Hamilton Genhave tonsils and appendix removed on the eral Hospital had ample accommodation for kitchen table. Treatment in a hospital meant public and private patients and therefore the need for another hospital did not really exist. certain death. One man thought it a thoroughly disagreeThree days later the newspaper, in an atable scheme "against which some united ac- tempt to weigh facts from both sides, fanned tion must be taken." Another said "I don't see the flames even more. By suggesting the cmx how they can be prevented from locating the of the problem remained the Catholic element, it revealed an abysmal lack of understanding about the intentions of the charitable Sisters: Our Roman Catholic friends have a perfect right to establish a separatehospital. They have a right to take all RomanCatholic patients out of the city hospital, or to take only those who pay and to leave the charity patients. . . . clf n76;,f;/fze,.r7 &/,toz itry -'"17'*'{ Thc bill of sab lot the purchase of Unilermount lrcm Bishop Thomaslosqh Doulingby the Sistetsof St. loseph Vieu from Chailton Aoenue of the 7894aildition to St.f oseph'sHospital. 20 The only objection to the separatehospital schemeis that it promisesto increasethe taxes of the general public for the benefit of the Roman Catholic church. To support his position, the writer noted that the property in questionwas worth $20,000 and (making the r.rsualallowance from actual value and the fact that $2,000of a clergyman's residence was exempt from taxation), he concluded that taxes were paid on $14,000, amounting to $256per year in revenue to the city. want, and which can onlyhave the effect of reducing the city's income without reducing its expenditure? The people of Hamilton have already provided their hospital and must pay for its maintenance. Why should they pay anything more for the support of a hospital which they do not Furthermore, the argument continued, the provincial government paid 30 centsa day toward the support of eachinmate of a hospital and the Catholicswould takethat income from thecity hospital for the patientsthey removed, without reducing expenditurein a corresponding degree. A final prediction was offered: "If one may irdg" by the history of the past, they will ask the city for a grant. In a word, they will remove paying patients from the city hospital and reduce its revenue, thereby compelling the general public to pay more taxes than they now pay, and, in addition, they will ask the Protestant portion of the community to pay for being injured." Thankfully, the gloomy Prognosis was inaccurate. Sufficient community support convinced the Sistersthat the time and oPPortunity were right to open a hospital. On June 11, 1890,they openedtheir arms and 25bedsto the city's sick The first of a long line of competent Sister administrators was Mother Philip Lenaten,64 who ran the hospital from 1890to 1894.After coming to Toronto in the 1840sfrom Wexford, Ireland, ]ane Lenaten, daughter of John and Ann, enteredthe convent. In 1853shereceived herreligious habit, along with the name Sister Philip, and with true missionary zealaccepted herfirst assignmentto Hamiltonthe following year. She also taught in the seParateschools establishedbyherCongregation.Between1859 l r;.'.", " t, /,. -' rl/ - * /-' /, - "'"o v'2-' -'/'{'' L'/. +/ td6. r, //o, .t1' tLJ, tt irt.tE z, et.8 r' 3t.t/ qt. at Eitst gooetnment rcport for the peioil of lune 27 to September30,7890- 2l and 1911she chronicled the eventsof interest within her religious community. Although anecdotesinvolving other Sisters were frequently recorded, Mother Philip seldom mentioned herself. ln '1862she was elected Superior General of the Hamilton Congregation,an officesheheld fornine years. Through her efforts, the Congregation bf tne Sistersof St. joseph was incorporated by the provincial legislature on Decemberfi, \829. By the time Mother Philip died in 1911,shehad spent 58 yearsdedicatedto the serviceof others. Lessthan five months after her death the hospital openedits own nursing schoolfor lay students. Under her administratiory the hospital's original 1890 staff was comprised of Sisters Antoinette Flahaven, 34, Camilla Carroll,38, Marcelline McGinnis, 34, Herman Sourbier, 32, and Bride Cleary,28. Father Jeremiah Ryan's last wishes were respectedwhen a ward was named after him and maintained for the benefit of poor patients. From the day it opened, St. Joseph's acceptedall patients regardless of their race, religion or ability to pay. An eyewitness account of the opening of the new hospital was published the followingday june 12, 1890in Tlu Hamilton EaeningTimes: The building proper is a large, solid, three-storey building, finished in the most perfect manner from cellar to garret. '/,'"- '. 1,.-<,V.'- - /-'7:^./'u "t Arccord of the first operationperformed at St. loseph's HosVital. At the entrance is a massive stone portico and balcony,and on the first floor, the visitor is struck with the wide halls and high ceilings, the spacious reception rooms and beautiful Chapel, which was previously the drawing room. The beautiful crystal candelabrachandeliers, which had been part of the former furnishing, added dignity and beauty to the new Chapel,in which thereis placed an exquisite altar, the gift of Contractor Pigott, father of Josephand Roy Pigott, Contractors, Hamilton, Ontario. /':--' 'i-' Record of expendituresfrom fuae 7890to lune 7891. Record of receiptsfrom fune 78%)to lune 7897, 22 The secondand third stories are divided into wards and private roomswhich areall well lighted, well ventilated, and also well heated.The walls and all the surroundings are of the most cheerful character,while the bathrooms and all furnishings are of the most approved styIe. The magnificent grounds are in keeping with the buildings. They are separatedfrom john Street by a solid stone fence, with stone coping and fancy iron finish, and a pair of huge iron gates. Altogether, it is a very beautiful spot, from which the patients can oversee the whole city and watch the boats floating up and down the Bay to the Beach. And on a clear day, a large portion of I^ake Ontario can be seen from the upper windows. Doctors Leslie, Stark, Wallace, Anderson, Bingham, Gaviller, McCabe and Osborne. Equipped with little more than Aspirin they battled major diseasesfrom whooping cougtu diphtheria and smallpox to measles and mumPs. The skill and compassionof the tiny band of Sisters,assistedby the doctors, were all that stood between life and death for many of the hospital's original patients. After a day de voted to the care of the sick, when the doctors went home, the Sistersstill had much to do. Laundry, food preparation, housework and record-keeping, for example, were all done without thebenefit of labour- and time-saving machinesthat are so taken for granted today. ln the first 12 months of operation, 163 patients made use of the 25-bedhospital. The demand signalled a need for expansion and plans were immediately underway. Onceagain On june 20 Dr. W. Rosebrughperformed the first operation in the new hospital. The patient was a 23-year-old Protestant worun named Mrs. Gilmour, a mother of three from Toronto. Chloroform was used for an anesthetic and the instruments were sterilized in boilingwateron an ordinarystove.The operation, to closea vesico-vaginalfistula, was successful and the wornn went home a month later. An attendingstaffof physicianswasformed on December 10, 1890.The first doctors to serve under its chairman, Dr. White, were Foreground,the oiginal hospital; centre,St,Ann's Wing, built in 78!X;far ight, 1916uing. 23 the Sisterswould be helped by the generosity of citizens. Bishop Dowling blessed On May 1,,'1.894, the site and turned the first sod for the new wing. Plans for the extension that would be erected at the western wall of the original Undermount called for a building 50 feet long by 30 wide and three stories high. The $12,000 cost was partially covered by a bequest from Mrs. A. Dowling the Bishop's mother. By December the St. Ann's Wing was complete. Thirty more patients could be accommodated in private rooms and semi-private wards. The ground-floor operating room had gaslight fixtures for operationsat night. A third-floor operating room had a granolithic floor (artificial stone of crushed granite and cement) which was easy to keep clean, eight windows anda skylight, as well as an adjacent room for the administration of chloroform. Also in 1894the first major gift was pre' sented to the hospital by an Anglican gentleman, GeorgeE. Tuckett, the prosperousowner of the Tuckett TobaccoCompany. Becausehe felt it was too strmuous for the Sistersto assist or carry patients up and down the stairs, he presenteda $2000 electric elevator to the hospital. His home, Mfile Cottage,is now part of the ScottishRite on Queen Street. Staff doctors routinely provided for the hospital's improvement at their own expense as well. In7902, Dr. Ingersol Olmsted paid for the instalment of electricwiring and fixtures in the operating room while Dr. Thomas Balfe furnished it with a complete set of surgical instruments. Soon the hospital was affectionately re' ferred to as St.Joe's.As the new century began the hospitalls artillery of weapons for disease In 7902Dr. Ingetsol Olmsted peid fot thc instellet'lon of elecffic aniing and firtures in thc opuetingrcom. Dr.GenrtlQaiglq managementor cure was almost non-existent. Drugs such as insulin for the control of diabe tes and the infection-fighters sulfanilamide and penicillin had not entered the medical arsenal.The therapeuticvalue of vitamins had yet to be recognizedso long as doctorslooked for the presenceofa genn - as opposedto the absenceof something in the diet - in conditions such as rickets, for example. Surgical techniques such as coronary bypass or the transplantation of any body parts - kidnep liver, heart, cornea - were simply unknown. Baffled by many diseases,health careprofessionalscontinued to treat the sick with a blend of the latest in medical knowledge, common senseand extraordinary amounts of devotion from the Sisterswho ran the hospital. The late Dr. Gerry Quigley, an obstetrician at St. ]oseph's, eloquently recalled his impression of the way the hospital was run: "Iay people are dedicated to their profession. In a Catholic hospital the nuru exemplified dedication to the gteater honour and glory of almighty God. They did it for God's sake,not for glory. You absorbedsome of this atmosphere, regardlessof your religion. Every ward was a chapel." 24 Chapter Four ASOULANDAMIND Credit is due to the dedicatedpeople who ran St. ]oseph's and to the community which supported it, financially or otherwise.But on more than one occasion,the hospital's patron saint was also commended for overseeing its success! The late Dr. Herbert Sullivan, Sr., who joined the staff after graduating from Queen's University in 1910,usedto say that when there were any worries about the hospital, the only thing that kept it out of trouble was the Sisters' devotion to St.joseph: 'The Sisterswere dedicated to serving others in need of health care, regardless of ability to pay, but the hospital always came up making its own way. What would you expect with the Sisters working from 5 a.m. to 9 p.*. every day?" Everyone had ample warning of Dr. Sullivan's arrival each day because he performed a brief, but unique, tap dance inside the front door of the 1890building. Then he and Dr. William P. Downes met in the cloak room, where they changedinto their white lab coats.Staff and Sistersalike were fond of the two men, who made rounds with such proprietary enthusiasmthat the hospital could be mistakenfor their own. later they would report to the Sister Superior, who was the hospital administrator of the time. "He would come through that big front door of the hospitaland everyone would stop in awe of Dr. Downes. He was so splendid," one nurse recalled of the former chief of staff. Not eoeryoneutme masksin the opetating roon of the 7930s. 25 "He was a small man but his word was the law. The Sistersrelied on him." One morning the two men came upon a janitor washing the floor right outside a room where a delivery was in progress. The door was ajar and the janitor, quite unconcerned, continued his mopping - not an acceptable aseptic technique where mother and infant were concerned.The man was admonished, but not beforeDr. Downes reportedly nudged Dr. Sullivan and pointed to the statue of St. joseph at the end of the corridor, saying "I guesswe owe him much more than we realize, because this is a very safe place to have a baby." Dr. Sullivan passed his love of medicine and of the hospital on to his son,who was also Dt, Herbert Sullioary St.,joineil thc hospital staff in 7910. named Herbert. The younger Dr. Sullivan joined St.Joseph'sstaff in 1952.His memory is rich with storiesand anecdotesabout the hospital over the years: I assistedDr. F. Woodhall in an operationto takeout a woman's uterus; he told me he had brought her into the world. The woman was chasing50,so that tells you how long he practiced surgery. He was a great story teller and must have had one thousand of them about the ear$ days. One day he told me about a young woman with an ectopic Dt. William P. Doatnesbeccmethc hospital's first internin7976. 26 pregnancy who was experienci.g a massive hemorrhage. It happened in the time before blood transfusions. Her abdomen was full of blood. He said he never knew what made him put his hand over to the other side of her abdomen before he sewed her up. He found that she had an ectopic there, too. It's so rare it would be like having two moons in the sky, but it shows you some of the skills that the older surgeons had. It was a senseof caution or something. Such faith, coupled with the fact that government controls and standardization had not yet been imposed, made it a relatively innocent period in which to practise medicine. In fact, a 1907report on St. joseph's by government inspector Dr. Bruce Smith said nothing of the calibre and organization of its services. Rather, it detailed the institution's size, facilities,visitin g hours, terms of paymentand noted that an addition was needed. In light of later developments, the report is more interesting for what it does not say than for what it reveals. When a new orbetter way to handle health care was discovered, however, St. Joseph's made every effort to incorporate it into its patient services. In 1895,Wilhelm Roentgen discovered a diagnostic tool which provided the physician with a Perrnanentvisual image of the patient's anatomy. Within a few years/ no hospital was consideredproperly equipped without an X-ray department. ()N'I'ARIO. OF PI?OVINOB, {}!' I)E}IART}IN:{|I Total '"' *ell fjome v*tds c.ovded. tto ere altogsther lxddi*g were Betr $PACIAL ol {rc, on wh gml clean aad ia dmr tlrere ia a*tand stairwa;e, There are ffve ittteriot order. Very OBffEBYSI): ITEATU&SS exape in we ald fair piPe vith {,*ilitics for }toic attlrehed {ire esealns or *ti. lhIec sirie of the building. The dietary The suppli* The rcords Numlprof ie suitable, and is propetly are fsrnished by contracl are aea|ly &nd correcilt dayrstay for put lear rl,ll portt of the hospilal were lound trut,sleen &rd well lsked bjeveral new bath-tulx l';utory *rll Tbe recoslr 30i 3{l 6-16 A nre&il erililg lrrs lxen cqnstructsl in ibe kitelxrr whicl i* improved rhereby. "' .. 341 305 6Jc 7. Aver@ dars stat 19.9. Infants under I ve*r' 1s' Adul* ls,?5i' i. 6;i;;a;". At-;uv' 'J fnftot" and Adulm' L3'?44' i' 9. " relief, etc' tho qere t@toeni' t6- $o. of pu*o" sho beve reived uon inmtes, 630. No' of Bedr mrde op 59' IL Dorrnitorl opaeity of bedr, 60. CLASSIFICATIONOF PATIENTS. pctpo*l. {or hoepii&l furnirhed lllrerc are mme repaii.s,printing ete- requiral in dillerent Farte o{ tLe Luildini4. f trlst thst an.increi* ond rvell ric*rrecl liberality towards t'his [,rpit*l will aritl v]r;rt i* necessarytll ii s equipment, l'hc fil:rncitl rl:Ln:rg{ailent- retums. of ile hospitll indierte carclul atttl prudcli lt, lY, SITUCN $MITE, InsPeetor' fh. BruceSmith's rqort ott St.loseph's in7907. storey's and ItN'Ncut. The builrling is brick. thre thereto. 'l' liet 9. Nnruher ol fre Eerls aoi 111, Chillrerr 96. Total !'airly 9, Feruoles }laler uidence, il of patienlr l{unber $ l0'3tl'0{ for p&st yetr for mailtenmce Erpe:rrlirure 'Iotal F 10,5i;-r''Js for p&st yeer' ". reeiptr !'irarcicl Tod ')3 -14 :J18 'jl-}2 ;?{ I90?. 12, litcEMEtrIi IlAMILTOlir, Tlre hospital should Lc, enl;rrgcd, ts.'t.L :l 9E{ ' ' - ' 968 306 di*beryul dariog ilre year' -.;-;il;;" 1. -r*o. r8 t+ 32 ;. sePt'3oth,leoi "-le in thelrosPit$t, ;. " ;;;& -l: -i }{Oi]PTTAL' JOSNPII'S $T. lst' I906 ' " " OT INPSCTICN OP rMffi Iai!. oct irt ll*pital, No. of rarients reuiniug admitted during the tear ' Ilirtbs * C}TAI{T'IIE!j A}{D HOSPITALfI -10.- Statistical Report t9o7 e{t€r bJ tle prcpared rld nicely scrverl. and open pureltost'. kept. 19,890^ ia good ordrr, Sirlere in clrargc lhis h$pit&l r-cr\ is drirrg r<xrd srrrk \!!l.i\ 327 3l{ i . lO' lr1 li6 Tutsl .. :]t? 1:5 1l: lJ. iAtIONALTfES:-Ceoada. ' .. 3+ ?0 lo1 Englcad.. -l:' :3 :]: . Irelard. . 16 6 l0 Scotlod. :, 11 6 unitcdsrate*...."-..... 12 23 16 Othe. Cooltries. Total..,. ever'.vthirrg ltilg L*ve replaeed tlte old ones aud aru iudicate lb.i Total, 616' Feuale 3'11. 1?. lJEt r*Mgle 305. 13. ITPLIOION :*Proteret6 of anv demoninetion. 155 li2 149 165 . . Booaa Celholic { I 0ther rligiors. f 5. FESIDEI{CE:-City of Flarrilton. Counry r:f \Venrvorth OlherCountier..-... l'nired$tet€s. 3'tl 616 '.3tt :Ji 4:t l: I ?67 t i :3 0 irl.l 96 it 1 arrl is *ol<irr:trrl. With the assistanceof Dr. ]ames Edgar, an X-ray department was opend in 1912with the latestequipment - an induction coil and glass plates. Developing was done in a darkroom acrossthe hall. Dr. Alec Unsworth, who had studied at the Mayo Ctnic in Rochester,Minnesota, instructed the Sisters in laboratory technique.While he was on staff at the hospi tal, Unsworth also had a private lab at Bold andlamesStreets,where outpatient specimens could be taken. Total . . 30ir 311 ij.16 Dr. Sullivan,Jr.,recalledthat Dr. Unsworth had a bit of a knack for farming, too. "Drring the First World War, Unsworth and the other doctors who were left behind thought they should do something about the food situation. Manpower was short, so my father and other volunteers would go to Unsworth's brother/s farm out in Aldershot. He had a greenhouse and on their Wednesdayafternoon off this is where they would go to grow tomatoes.It was the doctor's war eff.ort." 27 Equal measuresof zealand determination on the doctors' part were irupired by the Sisters' maxim "Look upon yourself as the servant of all. SeeChrist in others, and you will show them respectand reverence." Dr. Sullivan, Sr., demonstrated this principle in the way he encourageddoctors who were new to the city. Dr. Sullivan, Jr.,recalled: My father was a great believer in the open hospital. Anyone who came to Hamilton and wantd to start up a practice,he would give a hospital appointment so they could send their patients to St. Joseph's.This made for better patient care because then they would get the benefit of the Sisters and nursing care. It was better to give these doctors a chance.If the doctors were concerned about another doctor who was not quite up to the mark in knowledge or was doing some things (that they thought perhaps it would be better that he did not do,) there would be a discussion about expelling him or dropping him from the staff. My father was against this becausehe thought that a doctor cominginto the hospitaland being exposedto the otherdoctors talking about newerdrugs or new and betterways of doing things would, almost despite himself, get educated and fall in line more with the idea of conformity. The doctor would seewhatthe otherdoctorswere doing and learn that what he was doing was perhaps obsolete or outdated and pull his socksup. It was the idea of education rather than saying 'you can not be a member of the staff anymore.'My father felt thesefellows, if expelled, would still carry on practice and their patients would suffer, so it would be much better to keep them in the fold. It was often this simple humanitarian approach that worked best in solving a problem. But Dr. Sullivaru Sr.,also took a practical approach when the need arose, particularly where it affectedthe hospital's operation and the level of health care it offered. When the American Collegeof Surgeons(acs)sought to institute a standardizationprogram in 1918,he was quick to appreciate its combined aim of staff organization and more clinical controls, which were designed to improve the operation of Canadian and American hospitals. In a move that made his former approach quite relaxedby comparison,he called a meeting of St. joseph's medical staff on April 3, 7922,at 8:45 p.m. in the nurses' residenceto discuss the program and how it would be implemented. Although the minutes of this first meeting are limited to date, place, attendance and brief outline of its purpose, it is likely he explained the objectives of the plan, how they would bring about better medical service and the manner in which a hospital would acquire "approved" status. Theacsprotocol insisted on a careful, fully documented diagnosis prior to snrgery, re' cording of detailsof eachoperationperformed, improved qualificationsfor anesthetists,laboratory service run by a competentpathologist and a radiology department supervised by a qualified radiologist. Clinical records of all patients were to be completed. Doctors who failed to comply would have their privileges suspended until the requirement was met. Staff were to meet oncea month to review all hospital deathsand the number of autopsies in relation to the number of deaths. Standardswere also set for other hospital services.Food services,for example,had to be under the supervision of a trained dietitian. Depending on the degreeto which a hospital measuredup to this yardstick, approval was provisional or withheld altogether. It appearsfrom the records of subsequent meetings that co-operation prevailed when the staff saw the wisdom of conforming in order to achieve accreditation. Providing some of the impetus to the plan was the Reverend Charles Moulinier, S.J., founder of the Catholic Hospital Association of the United Statesand Canada. In a speech '1922,he sr;id delivered at St. Joseph'sin The plan of standardizing hospitals is a great international Dr.famcs Eilgar assistedin openingthe X-ray dqartment ir7972. movement,for if a hospital does not rise for better serviceto the sick,the peoplesuffer. The hospital is an institution with a soul and a mind, not merely a beautiful building. The staff of the hospital owesto its patients one hundred per cent service. The patient has a right to life. If among any of the medical men on the staff there is any knowledgethat would make a correct diagnosis of a case,the patient hasa rightto it. Wehavea right to all they have got to give. Only in recent years has the medical profession been big enough to realize that they are public servantsand it is only in the past few years that the public realized that the hospital is theirs. Father Moulinier's sentiments mirrored those of the Sisters,who exerted their influenceon the medicalstaff to ensuretheir patient qrre was notcompromised and that the hospital was sem to belong to the people. Determined to preserve and continue their fully accredited status, they. drew up the bylaws, rules and regulatioru governing staff and visiting physicianseffectiveJanuary,1924. These reflected the ecs model to the letter, from autopsy requiremenb and accuratecharting to educationand medical records.Of particular interest was bylaw number eight, which stated: '"We the staff of St. Joseph'sHospital are opposed to the division of fees,which we understand means any procedure between tion and, on occasion,unnecessarysurgery. It was by no means a custom peculiar to or limited to any one hospital, but it was particularly frowned upon by St. Joseph'sstaff. As sincere as their intentions mav have been,it was a difficult custom to moni[or and not an easyone to stamp out. Decadeswould pass before a particularly vigourous administrator would seethat this and similarpractices were overcome. Rules and Regulations' aDllllsslot{ Appliua[ts crrli6ed trv phy:icim to be fitsulrjectr for hospitol iretrrrnt irc rdmitted iaeslreciiseof their cr*d or u*tionalily. No inuae, ircunble, or ilfectiouc cM shall Ite ednilt d' P6lienL5 heving Doley or valuables &bout them will, ot entering tbe hospir*l vill not be leare sme rvirh the llister f3ecmi*ry--otherwie reslnlrsible fot loss or danage' On Nooember 28, 7922,Rm. Chailes B. Mouliniet, 5.1., etteflfual the opedng of Undermount, the rcut nurcing schooltnd Vromoted the standardization of horyital setoices,Photo courtesy ol the Catholic Health Associetion of the Uniteil Stetzs. FATIENTS Paticais must be in iheir reImtiee plam *t, ueal tioe, and rvhert the pbysician makes his vi6it" Petieilts rust nol teaee tb€ premilas, or visii ;rny parNof ihe lrospit{l vii,hout peruis$ioa from lhe $isier in charge. The uso of tolwco ig strietly prolribited in llrs w*rds. PaNientsin pd\.*te rsms must be ia bal by niae P.$. lights are tunred oui aN 9.30 P. M- vtstToFS f isitnn *re:rCuitted to to -1.s0 P. M. doctors themselve or between doctors and others, whereby practice is induced ordirected to any doctor in any nunner other than by merit, and especially are we opposed to the practice of a reward or emolument, directly or indirectly to those referring cases.We further recommend that this policy should beextended to all doctors practising in the hospital." The bylaw forbade the custom where one doctor referred a patient, often for surgery, to another doctor who charged a certain fee and then split it with the refer:ringdoctor. It was a practice that left itself wide open to exploita- fn case of d*lgeroug rclatives to siJii parierts tbe wards every rfuy in thc rveek {rour 2 illoess slreciol ai otlrer times. arraageuent$ can la made P*tient-s ccupying p.ivate rmms, nat see iheir friends any li frorn 10.30 A. )1. to 3 30 P. Y. Yisitos must no, gite eatablegsr liquorl of any kind to l}rrlients ; i soch ilrirrgs nre brooght they uusN be l€{t vilh the Sister in chargc, u'hr *rll tlispease them acording t€ the direction o{ the physieianVisitors de-siring to make any complaiut ivill kintlly commuuica *irlr the llother Suprior. TEFIMS Prtienlsshnll ln retluiredto pav in arlvanccSJ.i0 per rvccli in r rvards,,llurgiorl .vards 8{.90 per wr*k, ?rivate rooms range lrcm 8il 00 to $15.00 per rveek rceording !o and lccaiioa. An arlditioual {re of 8'5-00 rvill l*o}rarged to surgical cue*, for of operation roon and dressings. I)octors fe*, services of a special rrune, and msliciler are included ir the abote charges. lVards free to those uot gl']e to Hospital rules anil tegulations in the early yearc. dietetic work, scrubbed and cleaned.We did everything we were told to do! But I liked nursing and it madeno differenceto me whateverI was askedto do. We had nothing for the 1918 'flu epi demic except Aspirin and we were lucky to get that. Many a time I worked 24 or 36 hours without stopping. While fortunes fluctuated for many segments of the city's economy, the 1920swere truly vigourous years for St. Joseph's.The Sister Superior who directed many of the developmentswas Sister St. Basil M'Clarty, a petite woman in her mid-fifties who, though ladylike, was assertivein her pursuit of anything that would improve hospital servicesor facilities. -) Thc 7Y22hospitcl chepel. In a decadewhich would witness the be. ginning and end of the First World War, St. ]oseph's leapt from one milestone to the next in quick succession:in 1911 the nursing school opened; 1912 saw the establishment of the deparhnent of obstetrics;and a new surgical wing opened on October 12,19'l,5.It featured an X-ray department and laboratory space,a new chapel and a third-floor operating suite with the latest in sterilizing equipment. An eight-bed ward with a sun porch was added on eithersideof themain hall of the first floor to meet the need for increasedacconuno- *7"1 za,,:/ dation. Private rooms/ semi-private and fourbed wards were located on the second and third floors. SisterLeonieMartin was 23 when she came to work at the hospital in 1916.She attendedthe openingof theaddition connected to the west end of St. Ann's wing: Bishop Dowling, the doctors and the priest joined us for Mass in the chapel and lunch afterward. We had a good time. I trained under Drs. Downesand Sullivan. I bathed patients,did tr,u. 6. "J,:{*,,4.-" r'/!. ' Apaticnt's inooice shozosthe cost of surgeryand a hospital stay in 7922. Within months of Sir Frederick Banting's discovery of insulin as a control for diabetes, she applied n 1923for its use at St. ]oseph's. Connaught Iaboratories promptly responded. Dr. Fred Bowman was trained to administer the new therapy but, oddly enough,the excitement generatedby insulin is not reflected in the minutes of the medical advisory meetings. They merely state that on April 10,19?3, the doctors "discussedinsulin cases". Under Sister St. Basil's enterprising administration, St. joseph's expanded. Because an increasing number of young women were attracted to the nursing school, a new residence was built on the site of the old Undermount n 1922.Although roundly criticized for some of the more opulent touches- such as chandeliersin the common room and a sink in each nurse's room - she managed to get what she wanted. The following year, the obstetricsdepartment got a home of its own. br May, 1923,the Sisterspurchased the property owned by the firm of Long and Bisby at 58 Charlton Avenue East (formerly called Hannah Street) for $30,000.Converting the colonial-style home into a maternity hospital was a costly endeavour - an additional $42300 was lavished on renovations and furnishings. A HamiltonSpectator story praised the Sisters, saying "The Sistersof St. Josephare to be commended for their faith in undertaking so great a project when so much depression is clouding our land." The whole housewas renovated with steel laths, plastered and painted a snowy white. Amenities included showers on each ward, white marble floors and an electric signal system so patients could summon nurses. Be- anilelrit, ot Co.olro J@ f' aih., 1925. gt.Ae811, 8r. {. St. Jo6o!firs f,ospLtsl, geiLto!, Oatulo. ,ee kae;loa ead se dll l4eEltn rhesaler you allead.y atisrdea a eiL Eo6!1ts1, Iie{lb hsas asrgers ls he of sd uit. ft le"loa oJ st dll h€F least 6ih., Si, tbe s&e. rlth Las do las the ase of !to?e! 'b?o aort-hs. l, 111e toroBto at ldBu1h. lhe st ge w1lt roor tu the iiB Ideqltu cos'" teEFrature ne gl',a eeneld !ae, contlol. dd he6 Ihe tr1sa11D 1tB dietsjt sith loM at r€g*din8 cortRllh8;lld;Lgs seltsieJtoril5 ?, place ts ffohsa r€ceivea, EoEplial }!. ena€arolsa se be6E itrst tos?h'6 oJ:nstrEciloEs f&il1s! D€csssity v:a]s Js€ sqI}p1y leqolt€ hete tbo6e tL€ b to coase la Coslitee oaty suFl11ed ,sih€r of letter b€ rleased to i€ 3l^pe! :or strnrf,t e 4y 1do?n&tXo!, aoEs s{ceralt, _ /. ,),,a-i)-.llrEcio!' As6sciaie CcdraNghi -qEiitotk'leb6re?oria6. 3t,. r. A letter ftom ConnaughtLaborutorbs in responseto Sister St. Basil McClatty's rcquestfor insulin in7923, Dr. Frcd Boanmofl u)as tflifled causethe building was separatefrom the rest of the hospital, it had its own kitchen completely equipped with gasand electricranges, a refrigerator and an ice box. Underground pipes carried steamheat from a centralboiler. Elsewherein thebuilding, theoriginal black walnut and marble fireplaces had been re' tained. An operating room, doctors' change rooms and a room for sterilizing instruments were located on the third floor. Mothers and their babiesstayed on the floor below. Access to all floors was gainedby an automaticelevator. An oil painting of theVirgin and Child pre' sided over the entrance.CasaMaria, or House of Mary, was ready for occupancyon April 8, 1924. At 3:45 a.m. the following day Mrs. Bishop, the first patient, was admitted. With the help of Dr. W.j. Brough, Mrs. Bishop delivered a girl and christened her with the name C-asaMaria. The hospital at this point now occupied almost five acres.Lr an interesting about-face from its original objections- that the neighbourhood was unsuitable for a hospital and St. Joseph'swould increase taxes of the general public for the benefit of the Roman Catholic 31 to administct insulin. church - the Spectatorreported the day Casa Maria opened:"Its locationnearthesideof the mountain, its peacefulquietness,and its beautiful surroundings make it especially desirable. St. joseph's is indeed fortunate, and Hamilton is fortunate in having this restful, bright place,so well managed,where her citizens may go when ill-health assails." While statistics seldom make interesting reading, it is noteworthy that the hospital's 1925financial report indicates that of the 1,421 patientstreatedat St.]oseph'sin 1925,iust over 1,000 were Protestants and that $600 of the hospital's money was spent on the care of indigents, proving once more that the institution existed for the benefit of the whole community. A student wtse and Mr. E. K. Reiil, Phm.8., in the 1!30s phcffiac!. ..a""."r'/ a-.;-z---* r*z',:- r2.4.r, C4"; * /Z- Minutes of the first Meilical Adoisory Committee meetingheld on Apil 3,7922. By the end of the decadea staff residence had been built by Pigott Construction for $88,000and furnished for$3368. Interns earned $600per year while a registered nurse's salary ranged from $1,000to $1,825per year. The hospital engineer earned $1,560,the dietitian $900 and maids were paid anywhere from $216to $420per annum. By'1929St. Joseph'shad a bed capacity of 185 and provided medical, surgical, obstetri- 32 cal and gynecological care, an eye, ear, nose and throat clinic and urological, orthoPedic, pediatric and dermatological departments. The charge for a major operation ranged from $8 to $12, a minor one from $g to $0. L convalescingpatientpaidaslittle as$12.25Per week for a bed in the public ward and as much as $40per week for a private room. Quality of care was the same for all. Quite often it went beyond medical care.One Sister The Sistersof St.losqh purchasedCasaMaria for $30,000in May, 7923anil hail it reaooatedfor thcit obstetricsand matetnity patients. 33 used to take it upon herself to borrow flowers from thosewho had plenty and make up little bouquets to give to patients who had not received any. Prior to provincial health insurancecoverageand particularly during the 1930s,doctors acceptedthat many patients were unable to pay.Thegeographicalboundaries of a doctor,s practice often influenced his income, according to Dr. Sullivan, Jr.: In the depressiondays, collection would havebeenminimal, indeed.A doctor did not expect anything different. He knew when hewas workingfor them theyhad no money to pay him, but they still had to be looked after. Usually, enough could be made from paying patients so it was not any great hardship for theaveragedoctor.I do think that some people had a much heavier burden to share than others.For example,I know one doctor had an office on Ottawa Streetand his practice covered a big areain the northeast end of the city. He had to give a lot of medical care to some very sick people.On the other hand, it made a big difference if a practice were centred in the southwest end. Collection would be good. when a new maternity building was under construction. challenge of coping with Casa Maria's shortcomings required maintaining a senseof humour at all times. "It was a lovely place for patients becauseit did not have a hospital atmosphere, but it was a difficutt place to give nursing care," lv{ary remembers: Both nurseries w€re always futl. Sometimes we had to improvise and use hampers as basinettes. In the daytime, the temperature in the nursery could reach102F becausewe were so close to the maintenance equipment in the basement. This was iust around the time 34 In her typical New England way she told me shedid not care how fancy it was. She was more interested in the crucifix on the wall. That settled that issue and thaHs whereshehad our first child, Maureen. The Sistershave beendedicated to the family and family life, of which child-bearing is a part. It was a very sacredthing.I worked with some Sisters who were as good obstetriciansas - or better than - some of the staff men. Chapter Five IUBILEE-ANEW HOSPITAL During the 1930sand 1940s,St.Joseph'smediBy 1938,under the administration of Sister cal staff kept abreastof a growing number of Alphonsa Meegan, the hospital gained ap developments in medicine, drugs and treat- proval from the Canadian Hospital Associaments.Thehospitalcontinuedto receiveGrade tion for the training of interns. In addition, St. 'A'status from the American College of Sur- Joseph's organized a broader educational geons. curriculum in co-operation with other hospi- tals. Interns studied diseases of the chest through an affiliation with the Hamilton Sanatorium and nurses receivedpediatric training at the Sick Children's Hospital in Detroit, Michigan. At the monthly meetingsdoctorsdiscussed Th. sotl.t'/f,'ingctrt to,tylorthentwhoqitel.orplzt d tn 1947,l2lt to tight: Dr.l.f.P,'ry, DLHl.Sr.luo.a SL Dr. W-P.D@Es,Ilr.E. Wootth.U'Bkhap lX.Rfea Mothzr Antoin tE M.Bnt , Sist6 St. BesilMcdart!,l&cphPlgott, SisterSL EduardDtlfy, Sis'lr IEie B3t2r, si.rzr St.Bigid HalB' sist.r SyloiaSt.D6ie. 35 advancesin anesthetics,improved X-ray equipment, such diagnostic tools as electrocardiography, shock treatment for.schizophrenics and pertussisvaccines. '1.1,'1,938, On October Dr. Arthur Riley Armstrong of the Mountain Sanatorium addressed the medical advisory committee on sulphanilamide, a synthetic bacteria-inhibiting drug. Sulfa drugs, whose basic compound was first produced in 1908,did not gain wide' spread recognition until 1932,when they were rediscoveredfor their infection-fighting properties. Their use increased in the mid- to late 1930s.Drring the SecondWorld War the use of sulfa drugs fought off infection which, in the past, might have become severe enough to warrant amputation of a leg or arrn. The large white pills were best swallowed with a great deal of water, but they often left the patient feeling nauseated.As well, one of the side effects was that the body could build up a tolerance and require higher dose to ward off subsequent infection. konically, an even more significant infection-fighting agenthad beenidentified in 1928 by Alexaruler Fleming, who reported in the British |ournal of Experimental Pathology on his accidental discovery of penicillin, which rendered bacteria inactive. It took the carnage of the SecondWorld War, along with awareness of the shortcomings of sulfa drugs, to revive interest in Fleming's discovery. Delay in recognizing its value meant that when commercial production of penicillin begaruthe war was in progress. Consequentlp the drug was expensive to produce and difficult to obtain. As a result, penicillin was strictly rationed to the armed services. At St.]oseph's,penicillin was administered for the first time in 1943.A Sisterrecalled: We obtained it through the Department of National Defence for a veteran of the Second World War. I rememberhe was in room 1, bed three, of what was then called C-Floor. Penicillin looked like gold dust powder and it came in a little glass vial. The nurses mixed it with water and drew it up into a syringe. It had a terrible odour. Every three hours it was administered intramuscularly in rotating site on the patient's body. Dr. Meyer Carr was head of the department of pediatrics in the 1940swhen the wonder drug became a major headline: '1 was invited to comment on the radio about what a great advance it was. It was tricky to administer becauseyou gave a shot to the buttocks, which could be quite painful for the patient." The development of an intensive careunit 0cu) at St. joseph's was still 15 years away. Until then patients were sent back to their roorns following surgery. When more than general-duty nursing was indicated (and if a patient could afford it) a private.duty nurse functioned as the giver of intensivecare.'The concept of rcu round-theclock nursing care is safer, though, as Dr. Sullivan, |r., relates one patienfs experience: Aft er undergoing chestsurgery, a young run was returned to Dt. Meyer Catt anashead of pediatics uhed penicillin mcde heedlines. his room. Later that night, in a stateof delirium, he ripped out the drainage tubes which were connectedto his chest.Oncehe had freed himself, he iumped out of bed and escapedfrom the hospital. ln a pouring rain storm, Sister Lioba O'Dwyer chasedafter him along Charlton Avenue. The patient, despite his condition, proved tobequite elusive. When she realized she was not gaining on him, Sister Lioba comurandeerd a passing taxi and togetherwith the bemusd driver she caught the truant patient and brought him back to bed. Sister Lioba, who had enteredthe convent in 1915,was in her 50sat the time but it did not prevent her from rounding up a fellow half her age. Beforethe introduction of automation and labour-saving equipment to the hospital, the Sisters had a crushing workload. Three meals a day for an averageof 5,@0patients per year were manually prepared in a basementkitchen of the centre building. Dshes were washed by hand. Meals were transported in bulk by carts from the kitchen and served to the patients. Unlike today, patients had no choice in their mealsbecausemenus wereplanned well in advance. To maintain a high standard of hygiene, the kitchen walls were washed once a week. Baked goods were all homemade. Sister Mildred Szabo derribed the arangement of the kitchen she supervised between 1927and 1937: The kitchen had three refrigerators,one eachfor milk, vege tables and meat. The ice, which we made ourselves, went on top. Meat and bacon were cut by hand and wedid all ourown canningand pickling. We had a Chinesechef who was so protective of his lard supply that once, when one of the Sisters asked him for some, he brandished a knife at her! Without exaggeration, each $unmer we preserved 500twoquart size jars of strawberries and the same number of peachesand marmalade. The electricoven had three shelves. The bottom was for meat, the middle for baking and the top for toast or bacon. We could put 36 pies in at once. By the window we had a table with six hot plates,where we cooked. But they had fun, too. She laughingly recalled the time an excessof raisins was delivered by a grocery supplier: SisterLioba ODwyn, utho ran out into a raitry night to catch s runautaypatimt, btought comfort and cheet when oisiting p a tients. They said they had too much in their stockroom.I did not know whattodo with them.Afterwe had made raisin pie and raisin pudding, we still had someleft over, so we decided to make some wine. The raisins were mixed with brown sugarin four crocks and when it settled we put it in bottles. I said to Peter, the man in charge of the men's dining room (oneof severalstaff dining rooms),'Take this jug of apple juice in to the men and see how they like it.' A little while later he came back and said'Sister,the men say ifs the best apple juice they have ever had and they would like some more.'So,I gavethem more! Sister Mildred ordered the hospital sup plies on a contract basis - groceries from BalfoursLimited (Distributors of Tartan Brand Groceries),fmit and vegetablesfrom Rosart's and meat from Reardon Brothers, who sold beef,lamb or veal for 72.5cents per pound. By 1940,the 200-bedhospital was filled to In the early 7940sSister Rita Paul Fischer(left) and Sisterllrsula Barry attend to their patients, 38 capacity,asall availablespacewas turned over to patient accommodation. ln'1,939,a total of 3,894patientswere treatedat St.]oseph's.The following year,the number of patientsjumped to 6,769.By now the Sisters' reputation for dedicated service was well established and demand continued to climb. Their 50th anniversary was celebratedwith plans for a major expansion.In the sprin g of 1944,BishopJoseph Ryan approved the building of a new 400-bed hospital which, at a costof almost $1.5million, promised to be "second to none in the Dominion." A grant for 9177,000was received from the provincial government for construction. Once more, a grateful community cameto the rescue as a group of charitable women formed the hospital's first auxiliary, the fore. runner of today's Volunteer Association, to help defray additional expenses.OnMay ?2, 1945,a meeting of representativesfrom parishes of the city and the surrounding districts took place in the nurses' residence.Members of the first executive elected that day were: Mrs. S.H.O'Brien,PresidenUMrs. H. McGuire Mrs. B.V. Phoenix and Mrs. W.P. Downes, First, Second and Third Vice-Presidentsre. spectively;Mrs. D. Donahue,RecordingSecretary; Mrs. ].S.Pylypuik, Corresponding Secretary; Mrs. W.H. Grover, Treasurer, and Mrs. J.G. Smithbower/ Publicity. Plans for fundraising activities began immediately. The volunteers' philosophy was modelled on the Sisters'own - to help where the need was greatest. The results of their efforts ranged from practical to life-saving contributions to the hospital. Proceedsfrom events such as teas, card parties, dances,bazaarsand tag days enabledthe audliary to buy linen for the new hospital, purchase ecpiPment and make cashdonations. In subsequentyears,an $1,800instrument which automatically prepared tissue samples for post-mortem examinationswas donated to the pathology lab. Prior to this, the work had been manual and timeconsuming. Through theauxiliary's efforts, a central oxygen system was installed, which delivered oxygen to the patient's bedside and eliminated the need to move heavy oxygencylinders from the central storage room to wards and operating rooms. Each year the associationawarded a scholarship to a deserving shrdent in the nursing school and needy families received generous gifu of ctothing.Overtheyears,asthehospital grew and new needswere identified, the auxiliary always assisted. Under the administration of Sister St. Edward Drffy, then 56, the new hospital officially openedin May, 1.947,andthe public was welcomed to tour "one of the most modern hospital units on the continent." The crossshaped building was designed by William Somerville of Toronto and built by Hamilton's Pigott Construction Company. It embodied the latestarchitectural,scientific and mechanical ideas in hospital construction. Described in The Hamilton Spectatoras " . . . strikingly modern, dignified and stately in its distinctive beautf" , the building occtlpied most of the block from Charlton Avenue to Mountain Boulevard, which was later renamed St. ]oseph's Drive. When using the John Street entrance,visitors were greeted by thecomforting sight of St.joseph'sstatueabove the doorway. SisterSt.Edward's office was on the ground floor of the north wing. On either side of the impressive front hall were two spaciousvisitors'roonu. With high windows facing in all directions,they had the appearance of sun roorns. Patients were accommodated in the four wings that radiated from the central rotunda. A tower which formed the hub of the wings housedthe elevators and nursing stations,kitchen, utility and storage space, and permitted convalescing patientsin the wings to restundisturbed by the hospital activity. Efficiency in locating hospital staff was increasedwith the installation of a teleautograPh system,by which a messagewritten at the switchboard was recorded at all nurses' stations. These stations were decorated with dark green trim, stainless steel and red furnishings. Serums and blood for transfusions were stored in utility room refrigerators. The new building evenincluded a specialroom for flower arranging. Rooms for male patients were painted a soft green and equipped with wheat coloured furniture, while womens' rooms were painted a peachcolour and furni- In the pathology laboratory utith SistetAudry Schmidt are Dr. E.N, Ballantyne anil Ages Bruch. 39 ture had a limed oak finish. The kitchen moved from the basementto the main floor in the south wing and was supervised by chief dietitian Sister St. ]ames Culliton, then 48. She was a former nurse and a graduate of MacDonald lnstitute in Home Economicsin Guelph. Her new kitchen boasted many convenient appliances.Refrigerators now had doors that opened in front on the kitchen side and at the rear on to a conidor, SisterSt.EdwardDuffu where supplies were delivered and stocked.A Mix-Master blender eliminated most of the former manual labour in the bake shop and perhaps best of all - piping-hot food left the kitchen on trays along an electricconveyor to dumbwaiters which lifted them to the wards. Although an emergencydepartment with the level of sophistication l,arown today had yet to be establishedasa distinct service,space was dedicated to emergency medicine on the northeastcorner of the first floor. This areahad an emergency operating room and adjoining recovery room, 10 beds, waiting and consulting roomsand offices.Treating emergenciesin the late 1940swas still very much the family doctor/s responsibility. Dr. Herbert Sullivan remembershis father being called away from the dinner table to attend a child who had been hit bv a car: At the opefing of the 794,7hospitel the School Sistss of Notte Dame (foreground) celebrute Mass utith the Sisters of St. loseph. N He would not wait to finish his dessert. He would be up and out. One day we had chocolate pudding, which was a great favourite of mine. I could not see how he could leave it to dash off in such a great hurr)'. But there is no doubt that the parents of the child were de' lighted to seetheir family doctor arrive and reassure them that theirchild was all right. His fathe/s dedication was typical, Dr. Sullivan recalls. "All the doctors gave expert, personal servicein an emergency." Mother Philip Lenaten, administrator of St. Joseph'swhen it opened in 1890,would have marvelled at the sophisticatedtransformation of her 25-H hospital. An X-ray suite locatednear the operatingroornson the fourth floor had mobile units which could be taken to patients.The hrberculosisprevention division of the Ontario Department of Health installed X-ray equipment for the detectionof chestdiseases.The new building had sevenair<onditioned operating rooms equipped with shockand explosion-proof multibeam lights over the operating table. Two rooms were used exclusively for tonsillectomies, four for major and onefor minor surgicalprocedures.Nearby was a six-bed recovery unit where patients could regain consciousnessfollowing anesthesia. Instruments were sterilized in a highpressureautoclaveand, following orthopedic surgery, a department of physiotherapy assisted in patient rehabilitation. SisterAncilla Fagan,Phm.B.,managedthe With thc assistanceof Mary Eitzgaeld (meried name Marin) Bishop losqh F. Ryan officiclly opets the 7!A7 hospital uhib Dr. Willicm P. Dounes (fat left, front roan) Iooks on, efficient new pharmacy, which consisted. of two sections.Dispensing and workrooru were on the ground floor,thepharmacyand chemical rooms were in the basement. As chief pharmacist, Sister Ancilla was the first Canadian to win the American Catholic Hospital Association pharmacist's award for her outstanding contribution to hospital pharmacy.A first-hand witness to the vast expansion of drug treatmentsand pharmacyin the'40sand '50s,she insisted on reading about everything she handled and felt it was her responsibility to tell the doctors what she read and heard about new drugs. From the windows of private and semiprivate rooms on the top floor patients could look out to the Hamilton mountain or the bay. ln order to maintain sanitaryconditions,roonu were furnished with metal furnihrre which 4l could be easily cleaned. Care and consideration were given to the decor of patient roonrs on thewards. Walls werepainted with restful, pleasing colours - pale peach, warm buff, cool green or blue. D.apery in each room coordinated with the wall colour. Night lights in rooms and corridors allowed nurses to supervise patients without disturbing their sleep. Nursing and housekeeping staff welcomed the installation of two ground floor dumbwaiters in the new building. One sent fresh supplies - linen, instruments or medications - up to all floors while the other brought used articles down from all floors, thus eliminating the need to carry supplies. Two yearsafter the hospital's completion, St.]oseph'sspent $132,0@on the construction of a laundry building which was linked by a hrnnel to the hospital. It was opened on December 13, 1949.The equipment alone cost $34,000.A Cascadewashing machine, the first of its kind in Canada, featured automatic controls. The Sisters were proud of their air conditioned laundry facility with its terrazzo floors, buff-coloured tile walls and pale green woodwork It was efficient,sanitary, practical and altogether up-todate. Drring 1949, St. Josephls had admitted 17919 patients and performd.9,822 operations, compared to 163patients and 24 operations in 1890.Staffdoctorstookoverthecareof patients who were unable to pay for health care. The various services were organized under Dr. William Downes, chief of staff. The hospital was accredited in the following services with department heads: Surgery, Dr. Kenneth Murray; Obstetrics and Gynecology, Dr. A. Hollinrake; Medicine, Dr. C.K. StuarU Anesthetics, Dr. R.J. Fraser; and Children's Diseases,Dr. Meyer Carr. The post-war baby boom placed tremendous demands on the hospital's maternity department. As Sister Geraldine Campbell, Superior of the hospital at the time, explained: "!Ve are regularly turning away scores of mothers.Our capacityis not nearly adequate." At the close of the decade plans were well underway to build a new wing four times the size of the deterioratedCasaMaria. Provincial and federalgovemment approval was granted in November,1949,to the extent of 9290,0fi), although the total cost would reach $500,000. A sod-turning ceremonytook placeon December 8, 1949.Completion of the new building was expectedto take 16 months. Built in an Lshape around CasaMaria, which was still in use during construction, the new wing contained 80 beds and 93 basinettes,bringing the hospital total close to 500. The overall design echoed the master plan, with services efficiently located in a central tower. Grant Avenue, ]ames Sutherland, of "1.48 receiveda paid-in-full bill for the distinction of being the father of the first baby to be born in the new wing when it opened in ]une of 1951. Despite the building's numerous modern SisterM. Victor SchaeferandDr. O.R, Greenin the 7950sX-tay suite. Apaticnt in the X-ray rcom of the 7930sanil'40s. 42 amenities,nurseMary lv{arrinrecalleda couple of early problems. "Hot water filled the bowls the first time the toilets were flushed, causing them to crack.It took six months for telephone lines to be installed. SisterMarv RosePautler (who also nursed on the maiernity ward) worked so hard and we all pitched in." Nursesin the maternity ward worked nonstop throughout their shift. Infants were constantly under their care becauseat that time babiesdid not room in with mothers.Mothers were still staying from seven to nine days. Babieswho were waiting to be adopted stayed anywhere from six weeks to six months. patient. Shewas a very formal, very proper woman and although she was supervisor, they were short-staffed,so she helped. At the end of the night she looked so hot and tired, I suggestedsheneededa good, cold bottle of beer. She answered, (left) Marygrooe nurses'resideace,(cenfie)the new launilry building opmeil in 7919,(ight background) partial oicut of the staff residmce. Dr. Gerry Quigteyhad colourfulrecollectionsof the busv ward: Within a few years we were delivering closeto 6,000babies a year.The placewould go mad most of the time. I remember one unbelievably hot Sunday that I had spent most of the day lying on top of the bed with the fan on, iust trying to keep cool. That night I went down for a delivery wearing slacks, a sports shirt and bedroom slip pers. Patients were on stretchers with no beds to put them in after delivery. I sawSisterSt.Edmund Dales, in her habit, with sweat literally running off her as she ran with bedpans from patient to Sister Mery Austia Reding in thc busy t urcery. 43 'Don't mention it.' I went home, found a shoe box in the basement, took two bottles of beer from the icebox,wrapped them in paper, put them in the box and returned to the hospital. I asked the receptionist to call Sister to pick up the parcel before she went off duty. The next morning, as always, she was in the rotunda to greet every doctor. When I camein I asked her how stse was that morning. In her formal wap she answered,'I'm fine doctor. I had a wonderful sleep last night.' She never thanked me or acknowledged that she got the beer, except for that referenceto sleep. '?hysicians were made to feel it was as much their hospital asthe Sisters'," Dr. Quigley added, "so if a Sisteraskedyou to do thus and so, you would do whatever it was she asked." He assisted Dr. Hollinrake, the chief of obstetrics, at the first operation in the new gynecological wing. "Sister Eileen McKenna and severalotherswere in the operatingroom. She was poised with her camera. Dr. Hollinrake, the son of a Baptist minister, was a devout, wonderful man. Before proceeding with the operation he looked at the cmcifix on the wall and said, ,\rVewill iust say a little prayer that almighty God will protect the patients, the Sisterswho run this hospital and the doctors who work in it. Lefs go!"' Dr. Quigley remembers that those present in the room were deeply moved by his colleague'swords. "Sister Eileen was crying so hard shecould not take the picture." Sieter Eiber McKenna (bft) and Sister Eoelyn Riotdan assist Dr. Herbert Sullioary It. (l$t), Dt. Karl Kraft (background)and Dt. Frark Woodhall (ight backgrounil)in the 7!E0soperuting rcom. 44 Chapter Six PUBLICAPPEAL Dhortly after opening its 1947 building the hospital could barely keep pace with the demand for its services. Between 1941 and 1951, the city population had increased by almost 47,W to 180,000.Inthe winter of 1952, 14 patients crowded into wards designed for 12,forcing the Sistersto use corridors for bed sPace. By the following summer the bed shortage becamecritical when St. Joseph'sexperienced the busiest seasonin its entire history, caring for a daily average of 430 patients. In 1953, 't'8,689. Many paannual admissions rose to tients could not afford to pay the per diem cost of $11.15.Thehospital's financial report for the year revealsthat it managedto render $20,000 worth of free health care to city and county indigents. The bed shortagewas the topic of discussion at the November 9,1953, Medical AdvisoryCommitteemeeting.Onedoctorsuggested that perhaps patients were being kept in hospital too long at the expense of those who needed beds. "Discharge the ambulatory patients to an outpatient basisand make room for the ill," he requested.Iater, with the situation even more acute,came the plea "Keep minor ailments at home. If ifs a real emergencywe'll find room but be fair to your colleaguesin the diagnosis of an emergency. Discharge your patients as soon as possible." The opening of a new chapelin 1955alleviatedsomeof thecrowdingbecausethe old one Thc Fiesen concept at utork: Sistet Mary Ro* Pautler pushes the button for the floor ilesignated to rcceioe items was converted into a department for physio- ftom the trayoeyor. 45 realizethat simple economicscompelled them to do so much of the workthat formerly placed them in the public eye.The maxim "Seekneither praise nor recompense for your good works in this life, that you may receivemore enduring reward in eternity'' reinforced the Sisters' efforts to provide health care to all citizens. SisterAnn Marshall took on the responsibilities of a night supervisor at the ageof 24. Nursing Sisters, she explained, were put in supervisory positions for financial reasons: Itft to ight:Dr.Williamlamieson, and Dr. Frank Woodhall. Sistet Geruldine Cempbell,Dr.William P.Dozoaes,Dr.Herbert Sullioan,fr., therapy. Enhancingthe chapel's simple, modern style were mosaic stations of the cross made in France and a larger-than-life-size crucifix handcarved by ]oseph A. Gause of Hamilton which formed the focal point of the main altar. At the chapeldedication, Hamilton Bishop JosephF. Ryan said, "In a Sisters'hospital, the chapel is the most important unit of that building. All other parts have a specific purpose and promote certain good ends, but for the Sisters,the chapel is the all-important place." Despite the cramped conditions, the Sisters were loath to refuse treatment to those without means. Sister Geraldine Campbell rigidly insisted that "no matter how crowded the hospital is, indigent patients will never be refused admission." In 1954pay increasesto existing staff and the hiring of additional personnel to cope with the workload drove up room rates by one dollar per day. The ward ratewas$7perday; three.andfour-bedrooms were $8; semi-private $9 and private ranged from $9.50to $14. A decision made by Hamilton's Board of Control in 1956helped easethe burden of debt created by unpaid medical bills. Controllers agreed that the city would pay $10,000to St. Joseph'sfor the care of indigent patients during the first six months of that year.It was also decided that, commencingjuly 1,the county of Wentworth and the city of Hamilton would pay the actual costs incurred for the care of indigents. The Sistersappreciated the financial boost,although it by no meanssolvedall of their problems. The Sisters were reconciled to working harder and longer in order to make endsmeet. People who regret that the Sistersare not as much in evidencewithin the hospital may not Therewas no government fu nding at that time. A Sisterwould work from 7p.m. to 7 a.m.,with a registerednursecoming on at 11p.m. to help carefor the 400 patients. Student nurses also staffed the floors at night. After finishing a six-month stint of nights I was put in chargeof pediatrics,becausewe could not afford to pay anyone else.Titles were not important to Sisters. A Sister would do one job, be transferred or assigned elsewhere. It did not bother us, but it would not be fair to do that to a lay nurse. After the Sisters finished a shift, they did any work necessary to keep the hospital going. A lot of patients were cared for who could not afford it, which is why we went into the busi ness.Thereare still people who can not afford it. That is what we are all about. In the late 1950s,when the provincial government introduced a hospital insurance program, the number of patients who sought treatment at St. Joseph's multiplied again. Often, in the X-ray department as many as 80 patients- somein wheelchairs,othersin beds, many with arms or legsin casts- spilled from waiting rooms into corridors while they waited to seethe radiologist. Laboratory staff took blood samples at makeshift tables when the small consulting rooms were full. The labs carried out half-amillion services each year. On the pediatric floor asmany as 70children were wedged into a ward originallydesignedfor35.Dining roorns and playareasweresacrificedto provide extra accommodation.Emergencycasestook priority over children whose elective surgery had Gooernor Gencral GeorgesP. Vanier and Madame Vanicr (centre)on an tnofficial oisit to St.loseph's duing construction of the new surgical buililing, 11 sometimesbeen deferred for months. A backlog of 2,000 patients waited for surgeryin the operatingrooms,which handled 50 operations daily. After delivery of their babies, many women rested on stretchers in the hallway (where privacy was non-existent) until a room becameavailablein the maternity ward. Doctorswere forced to ask mothers who had been in St. Joseph'scare for four or five days to leave as soon as possible. The discomfort and inconvenience for patients and staff dishrrbed SisterMary Grace Stevens,who becamethe hospital administrator in 1954.Shestarted making plans for a new SisterAnn Marshall hospital and knew exactly who she wanted to design it.In the early 1940sshe had met Gordon Friesen, a hospital consultant, whose design principles were considered quite radical at the time. He stressedautomation and a streamlined flow of goods andservices within the hospital. It was a concept already familiar to industry, where, for the sake of efficiency, labourers on the production line have the materials brought to them. When applied to the operation of a hospital, however, this approach had the added advantage of allowing staff to maximize the quality of care rendered to the patient. Sister Mary Grace was enthusiastic about Mr. Friesen'sideas and determined to hire him to design the new hospital. To demonstratethe need for expansionto Mother PaschalCollins (Superior Generalof the Hamilton Congregation at the time) SisterMary Graceinvited her to tour St. ]oseph's. But Mr. Friesen'sinvolvement in the proi ect was almost curtailed when Sister lv{ary Grace mistook the Superior/s silence for consent: When we had a desperateneed for more spaceI asked Mother Parhal to come and tour the crowded hospital. I took her around and even showed her the packed store' rooms. We needed someone like lvtr. Friesen because of his experience.Well, Mother Paschalwas a woman of few words -but she gave me the impression that she agreed that I should hire him, so I did. When she found out what I had done, she told me that no one had given me permission to hire him and that I had no business doing it. I really got the dickens for that! You see, initially my advisory council did not agree that we needed his services.SoI called Mr. Frie. sen and told him the job was off. Obviously, he could have charged us for half of his re. tainer fee,which was $150,000. But hedidn't. A little while later, I did get approval. amounted to a substantial sum, which they applied to enlarging and improving the hospital whenever necessary. Local taxpayershad relied on the hospital for sevendecadeswithout ever being askedto contribute to its financial well-being. But the scopeof the building program the Sisterswere about to undertake was the most daunting sincethe hospital opened. In November,1960, William Scully, president of the SteelCompany of CanadaLtd. and generalchairman of the hospital building fu nd, stressedthat St. ]oseph's request for community assistancewas a reasonableone. "St. Joe's hasservedus faithfully for over 70 yearswithout ever knocking on our doors for help," he In the late 1950s,if the city had endeav- said. "I am confident that, with realistic supoured to replace the hospital altogether, an port from all segmentsof the community, we estimated$14million would havebeenneeded. will reach our objective. After all, it is really The cost to build, furnish and equip the new St. our own health we are being askedto protect." Almost 700fundraising volunteers,organ]oseph's,on the otherhand, totalled $8,450,000. Grants from the federal and provincial gov- ized in teams,launched an intense campaign ernments, along with a $1 million commit- in February,'1.9 6'1.. They called on corporations ment from the Sisters,made a construction and small businesses,merchants,private indi start possibleon May 4,79ffi. As well, the city viduals, health care professionals and the of Hamilton made its first capital grant, in the general public. Donations soared to $1.6 by amount of $2 millioru to St. |oseph's. April. To raise the balance,30,000employees Buta shortfallof $2,49p,000 erdsted.Forthe in major industries each received requests for first time in the hospital's history, the Sisters a $3 gift commitment - at a time when the were forced to turn to the community in a average weekly earning in Hamilton was major public appeal for a specifiedamount of $85.84.Less than two years later Mr. S"rlly financial assistance. proudly announced that the responseto the Over the decades,St. Joseph'shad been appealhad beenoutstanding and that the fund able to expand through the Sisters' sound had reachedits objective. management, tireless efforts and the donation Mr. I. Pigott, chairman of the hospital of their own services. Rather than receive fi- advisory board, praised the community for nancialreward fortheir work, they setasidean the successof the fundraising campaign. "The amount equivalent to their combined salaries broad scaleof giving is both a testimony to the from the hospital's income each year. This generosity of Hamilton people and colpora- tions and a grand tribute to the very high esteemthat everyoneholdsforthe Sistersof St. ]oseph. I know that many gifts were made in respect and honour to the dedicated lives of the Sisters,"he said. After operating the hospital from 1954to 1960, Sister Mary Grace was transferred to anotherjob at St.MaI/s Hospital in Kitchener. Although she left St.joseph's before constmction began, her dream of an ultra-modern hospital became a reality. The new building was officially openedby Premier JohnRobarb on October 77,1962,under the administration of SisterSt. Paul Iardie. Working with architects Prack and Prack of Hamilton and hospital consultantsGordon A. FriesenAssociatesInc. of Washington,D.C., Pigott Construction completed thebuilding in 18 months. Built in the shapeof a rectangleon an east-west axis, the new hospital was finished in light greybricksharply contrastedby blue glazed panels. It occupied most of the block between james and John Streets. Although its basic location remained the same, St. Joseph'saddresschanged from John Street to 50 Charlton Avenue East becausethe new main entrance was situated off the Charlton Avenue parking lot. The emergencyentrance faced ]ames Street. The exterior of the eight-storey building was architecturally simple, but housed within it were innovative ideas in hospital planning which blended fonn with function to serveone essentialaim - to increase attention on Patient needs. Diagnostic and clinical services,as well as administrative offices, were located on the first floor. Dietary facilities - the kitchen and staff cafeteria- were on the secondfloor. The third to the seventh floors were deigned for patientcare.Thebed totalhaddoubled to 800. A pediatric ward on the third floor had 96beds and on each of the other floors there were 75 beds for patients undergoing general surgery, thoracic and plastic surgery, orthopedic surgery as well as gynecological, genito-urinary and ear, nose and throat care, plus ophthal- mology, and neurosurgery. The Sisters who worked in the hospital lived on the eighth floor. Rooms on the south side faced the tree' covered escarpment, which presented an attractive vista in any season.On the north side, the patientscould gazeout from their rooms at thelovely old homesin a neighbourhood which The Sistcts host e rcception fot men anhodesigneil anil built the 1962 sutgical buililing, *afud left to ight : Sbtet Audry Schmidt, f osephPigott, Sistet St,lcmes Culliton, Ludaig Giadl, Sistet St. Paul Lardie, Staniling left to ight: Emile Dubois, Alvin Pnck, nnidentifieil man, foseph Pigott' fr, 49 had onceresistedthe hospital's establishment. Bright, spacious corridors running the length of the building provided accessfor staff and visitors to the patients' rooms.Paralleling the outercorridors was an inner one,to which only hospital personnelcould gain entry. This inner corridor contained the heart of the Friesen concept.Located within it was a retrievalsystemforthe exchangeofclean and soiled supplies. This system eliminated the possibility of patient exposureto infection and to noisy, routine hospital activity. Becausethe exchangeoperatedon a 24-hourbasis,it saved the staff from unnecessaryjourneys to obtain supplies. The retrieval system's master dispatch centre was located in the basement.Arranged around this centre were the sourcesof supply - fresh linen, medical supplies, medications, instruments - which were distributed to the floors in a number of ways. Small items such as records, emergency orders for supplies, X-rays and prescriptions were quickly transmitted betweendeparbnents along a pneumatic tube. Automatic trayveyors with a 40-pound capacity expedited supplies through two vertical stainlesssteelshaftswhich kept cleanand soiled articles separatefrom each other. One carried clean supplies to the selected floor Sistet St. Paul Lardie uith Mr. Abin Prack of prack and Prack, Architects. W?:l oPellr'Sotry'ryqLcelbuiltirg on odoba78,7962.Izlt to ttgtt:Plen'tcrlohnx','.ane, Moth.r Atd.oq/. H,yes, Sbtcr SL PcirlLArdi., M.fot Llofdle*'oa v,tilliaw Scl/.tt!,Postmrcta-cene/{,l EuznEetrctotglt 50 Theswgte.t}44',?.i,'gon a'rlton i,t7!X2: Ao.'u., co6?A.d while the other returned used items to a decontamination centreand the centralsterileareain the basement. To selectthe floor for which the supplies were destined, an attendant simply pushed a button in the dispatch centre. Becausethis trayveyor had an automatic ejector device, staff did not have to be present at the designateddepot to unload it at the time of delivery. A generalservice elevator for items too large for the trayveyor also served all floors. Another elevator served the kitchen. A pharmacist prcpsles a prescriptiott fot its jouney along the pneumatic tube. Anur* retrieoesftesh suppliesfrom the nursenter without leaoingthe patienf s room. A core ettefldant rc-stocks thc nurxntet with fresh strypliesfrom the halluay outsiile a patient's room. A holdingarea forsoiled items in the centre conidor containeda trash chute to an incinerator in the basementand a chute for dirty linen which linked to the laundry room. The system ensured a constant rotation of new and used goods. Individual supplies, according to the patient's needs,were picked up from the depot on each floor and distributed via mobile carts to a specialcabinetcalleda'nurserve/, located at the entrance of the patient's room. This cabinet,situated in the wall between the corridor and a serviceareain the room, had a door on each side which allowed for an efficient exchangeof new and used items. It had three advantages: the patient was undisturbed by constant traffic in and out of the room; the nurse spent lesstime running to fetch or requisition supplies needed from a store room and - the most significant - the nursespentmore time with her patient. Sister Mary RosePautler was responsible for overseeing that this Supplp Processing and Distribution (sno)system got a smooth start in the new hospital. "Mr. Friesensent me to observein a hospital in SanFernando,Cali- 51 fornia, where they had a system similar to the Friesenconcept.It was foreign to me and I had to get an idea of how it worked. When I re. turned to Hamiltoru I worked closelywith Mr. Friesen," she recalls. "The attendants who re. stocked supplies in the nurserver becamevery knowledgeableand it got so they could anticipate needs. It made a big difference because before that the nurses used to have to run back and forth to get things themselves." Today this spp system remains the most efficient method of distributing supplies throughout the hospital. The concept affected the location of other deparhnents as well. Sister Gerald (Beatrice Schnarr) worked in the pharmacy when the new hospital was in the planning stages: Becauseof the Friesen concept we had to be in the basement, close to the dispatch department. Sister lvlary Grace was very kind and trusted us with the planning of our own de. partment. In the pharmacy we had a tremendous team of enthusiastic peoplewho did a lot of innovative things and this enabled us to give better service to the patient. It was a time when the pharmacy became more specialized. Unit dosage was introduced. We had a sterile room where we made a lot of our own iniectibles. In the 1960s, clinical pharmacy was introduced. The medical professionincreasingly depended on pharmacists. Confidencedevelopedbecause the pharmacists knew a great deal and could give accurate information that the doctor did not get through other sources. We checkedto seeif drugs were compatible or if they would cause an allergic reaction. Pre scription orders were carefully edited. Audio communication was another feature of the new building that helped the nurse attendto herpatient'sneeds.A two-wayintercom at the patient's bedside was connectedto the nurses'station. Without leaving her desk the nurse could find out what the patient needed and get it there twice as fast. Also at the patient's bedside were push-button controls for radio, television, or recorded music and stories. Elsewherein the building, most notably on the first floor, facilities and departments with Sister Eibm McKenae talks to c grudtate nw* uthile e studett nutse usesthe neut audio communication system at the nutses' ststion. 52 related functions were grouped together to optimize efficient patient care.The 12 operating rooms, the most modern in Canadawhen thebuilding opened,were set in two banks of six with a sterile corridor running between them. To avoid any form of contaminationthat might endanger the patient in the operating room, sterilized instruments and equipment were brought through this cleancorridor. The oR personnel, after scrubbing to ensure they were as germ-free as possible,used the same entrance. Becausecombustible gasesare used during surgery, a machine was installed at the doorway to detect on the surgeon any static electricity which might spark and cause an explosion. For the same reason/ oR nurses were not allowed to wear any nylon articlesof clothing. All operating room staff wore cloth overshoes with a metal strap in the sole to ensure that they were prop€rly grounded. New equipment was introduced into surgical procedures.Two of the operating roorns had overhead X-ray units built-in. During surgery, the surgeon could seea continuous, amplified X-ray of the patient on a closedcircuit television screen.The anesthetistcould also monitor the patient's heartbeat, which was representedasa pulsing line on thescreen of a machine called an oscilloscope. In the eventof a power failure, thehospitalls dieselauxiliary powerplant madesucha rapid changeoverthat there was no intemrption to surgery in progress. Sister Mary Daniel Weadick had worked in the operating room since 1950 and witnessed the doctors' transition into areas of specialization in surgery. She was eager to ensure the on nurses would develop skills to a corresPonding degree.Beforemoving into the new building she approached Sister Virginia Hanlon, Director of Nursing, about havinga chargenurse in the on for each specialty: I told Sister Virginia that I would like to see the nurses receive some special training. As a result, onewent to Toronto to an orthopedic hospital and another went to Boston to an eye clinic. By the time we moved into the operatingrooms,eachnurse took over her specialtyand she could then teach the others. When the surgeon came in, he knew exactly who he should speakto when he neededsomething. This gave the nurses a greatdeal of satisfaction.I could not possibly be responsiblefor the thousands of dollars worth of instruments. I blessed Sister Virginia be cause if she had not agreed I would havehada much harder time. I remember being told when I was in training that when you are in charge of an operating room and you go on vacation, it should run iust as smoothly aswhen you arethere. If it doesnot, thereis something wrong with your supervision. You are not delegating,you are holding on. Ao tfr" hospital turns into its secondcentury of seryice, a new team works in the phalnacy - 17 staff pharmacists, three supervisors,three administrative staff and assistantswho perform techt? p$t**y nical functions. By consolidating pharmacy resources and drug inventory, this systemeliminates a u*oc6*uming ctroreior n.usiogstari. Ratherttrar spenf,hourseachdayJbrti"g patient medications into containers for reqrisition from the hi"trilt uor,, n*o, pharmacy drugs which are needed for a 24hou1 period. The required medications are-paCkagedin single unijs.by phar.macy technicians and dispensed in a ready-to-administer form. distribution has numerTil;;h;J; ousadvantages.The most noteworthy improvements are that it reduces the incidence of medication etror, makes more efficient use of nursing and pharmacy personnel and reduces the size of drug inventory in patient care areas. Through the establishment of clinical pharrracy, patient care improves because pharmacists are involved in the education of thosewho consume,prescribe,dispense or administer drugs. The unit dose system is appropriate for about 85 per cent of drug distribution in the hospital. The remaining.lS per cent are prescriptions made in the pharmacy 'kitchen' or in a room that provides a sterile environment where intravenous inlections - nutrition solutions, for example, for patients who are unable to feed themt selveslnr€prepared. Once out of surgery each patient was wheeled across the hall to the new 33-bed recovery and intensivecare unit. The proximity of this department was planned to minimize patient travel at the critical post-operative stage. Until patients were ready to be transferred to a nursingfloor, they wereunder the constant vigilance of specially trained nursing staff who used sophisticated equipment to monitor vital sigru and progress.The addition of an intensive care unit was also beneficialto patientswho wereadmitted to the hospital in a critical condition - severeburn or accident victims or those suffering from cardiac arrest. Dr. Herbert Sullivan, lr., explained the advantage of having patients in critical condition under closeobservationin oneplace."The nurses in intensive carewere specially trained and would be doing the same thing over and over again. As a result, they could give the patient better carethan if the patient were sent back to a floor where perhaps the nurse had not caredfor a patient with a lung re.sectionin six months, for example." Patients who required treatment on an outpatient basis or those arriving for scheduled admission to the hospital had easyaccess to the building from a front entrance off Charlton Avenue. Emergency cases were brought through an entrancelocatedon ]ames Street. Diagnostic services - radiology and clinical laboratories - were strategicallysihrated near outpatient and emergencydepartments as well as the operating rooms to facilitate speedy, convenient service. The major benefit of this arrangementwas that it caused the least amount of inconvenienceto patients becausethey didnothave to travel throughout the hospital for X-rays and blood tests. By the early'60s,emergencymedicine had evolved into a distinct department of its own. The fact that 50 to 50 caseswere handled each day meant that separatequarters were warranted for the busy department.Patientswere brought through a sheltered ambulance entrance to an emergencytreatment area on the left that consisted of four examining rooms, four operating rooms and four observation rooms. To the right of the entrance was a waiting room where friends and relativeswere kept clear of the patient<are activity. The department, with sophisticatedtechnology and highly trained personnel dedicatedto emergenry medicine,signalled a dramatic departure from the days when the individual physician hurried in to carefor his own patient. Dr. Herbert Sullivan, Jr., explains the different strategiestried over the years: Initially, the family physician handled his own emergency cases.The secondstage in de. velopment of an emergency departrnent was when interns arrived at the hospital. It was thought to be a good thing to have interns look after these patients. They were called to deal with the most life-threatening situations and they did very well consideringtheywere the least experienced staff members. Conscriptionof generalpractitioners was the next stage.If you were going to be on staff at the hospital,you were expected to take your turn in the emergency room. This meant physicians took an eight- or a 12hour shift every six weeks or three months to see that the hospital was protected by having a competent emergency doctoravailable.Theadvantage to a young doctor with this systemwas that he might build up a practice through the patients he met. For a more experienced,mature doctor, the snrotation was more of a drawback, particularly if he were on the midnight to 8 a.m. shift and had a busy day planned at the office.Quite rightlp he would want to give priority to his own patients. Evenhrally it was recognized that with specialization developing in other departments,the samewas neededin emergency. You had to have someonevery skilful in handling, for example, a cardiac arrest with all the complicated new equipment and drugs. You needed a specialist in emergencywork who could master the latest intricaciesof handling a personwhose heart has stopped for two-anda-half minutes. New equipment also helped improve the handling of emergencypatients.For example, in the caseof an accident victim with a back iojury, St. joseph's introduced the use of a stretcherupon which a patient could undergo X-rays, treatments and surgery. This type of stretchereliminated the need for the patient to be moved more than once,which might aggravate the injury. Still standing over the former emergency entranceis a 12-foot statue of St. ]oseph with the infant Jesus.The statue,sculptedby Joseph A. Gausewas made from fired clay and done in green,beigeand white with a ceramicfinish. It took Pigott Construction 10days to erectthe 1,800-poundwork, which was an anonymous gift to the hospital. Although it is slightly eclipsed by the west wing built in 1987,the statue of St. Josephis still visible as one ap proachesthe hospital from Herkimer Street. Administration and businessoffices were logically grouped together on the north-east corner of the ground floor, away from treatment and patient-careareas. A bright, blue-and-white tiled kitchen on thesecond floor of the newbuilding was ready for occupancy in November, 1962. After'15 years as dietitian in a small, cramped kitchen, SisterSt.JamesCulliton, then 63,marvelled at her expansive new quarters. The petite Sister with twinkling eyes feared she would need roller skatesto makeher way around its 13,000square-foot area. Atl equipment was made of stainlesssteel and work spacewas dedicatedto the appliances'various functions - four 60-gallonelectric soup pots, electric and gas ovens, and a heat-controlled cabinet for raising yeast rolls. Other state-of-the-art equipment included a $15,000automatic dishwasher,a $12,000automatic pot washer,a cancrusherand a garburator. An elevator to the basement linked the kitchen with its two walk-in refrigerators and transferred from the trayveyor to the attendant's cart to be delivered to patients in the wards. JoyceGilmour worked with SisterSt.]ames for a year before the new kitchen opened.She was very fond of the Sister who, in 1963,decreed that Joyce would be head dietitian. '1 rememberSistersaying to me 'Thejob is yours. I hope you want it becauseit's yours anyway.' That was just shortly before she died." Mrs. Gilmour recalled: Sistet St.Pad Lardie and losqh Pigott of Pigott Construction Company. walk-in deep-freeze. Each dap Sister St. ]ames and her staff prepared 3,CI0 meals. The new cafeteria accommodated280patrons,who couldbeserved at a rate of 20 per minute. The enlargeddining area,with floor-to-ceiling windows overlooking St. ]oseph's Drive, meant that hospital personnel no longer had to eat in shifts. An automated trayveyor that lifted food from the kitchen enabled 800 hot meals to be distrib-' uted to patients throughout the hospital in 90 minutes. Three minutes elapsedbetween the time food left the kitchen and when it was Apart from the routine meal preparation, the therapeutic diets required at the time were of a generaltype and comprised about 30 per cent of our workload. What we did would be considered run-of-the mill by today's standards.We took care of reduction diets for orthopedic or cardiology patients and had the occasional malabsorption case. Diabetic diets were always challenging because the diabetic is very much an individual. When the kitchen was planned, no one realized how the clinical aspect of nutrition would take off. We did not have McMaster Medical Centre, a dialysis department or the sophisticateddemandsthat are made on our profession today. It was not asscientifically structured. We have grown and done well. A population more knowledgeable about nutrition is placing more demands on the dietetic profession. They are better educatedand informed. They want to know what the end or hoped-for result (of following a particular dietary regime) witl be. With increased knowledge and researchn nutrition developed areas of specialization, too. Today clinical nutritionists are an integral part of all facetsof health careprovided by the hospital, from pediatrics, maternity and the intensive care unit to outpatient counselling, medicine and psychiatry. They work as part of the medical team, attend rounds and conduct detailed nutritional assessmentson patients. Sister Norinc Mooney, head of the ailmitting ilepsrtmeflt in t E 7!X0s. 56 Whm nutrition problems are identified, clinical nutritionists plan, teach and monitor individualized diets. In order to give directions for therapeutic dietary treatment, they are required to have a good background knowledge of diseasestatesand physiology and be able to interpret bloodwork In those early days, Mrs. Gilmour realized things were moving so fast that there was no way they could keep up on everything. "I decided we needed areas of specialization. Dialysis proceduresprecipitated this need more than anything else.You could not go on with sying to the dietitian, This is your floor and everything on it is yours.'" The design and plan of the new St.Joseph's perfectly coincided with the era of specialization in health care.SisterMary Grace,who had returned as administrator ir:r1963,had taken the necessary steps to guarantee that the hospital's reputation and calibre of service were above reproach. In her view, the best possible facilities warranted the best possible rnanagementand operation and she saw to it that St. joseph's offered the citizens of Hamilton-Wentworth a healthy return on their investment. Chapter Seven A PERIODOFGI{ACE Y\ lJespite the budget and spaceconstraintsthat dominated the 1950s,St.Joseph's made tremendous advances on many fronts. The efforts of a medical staff dedicatedto improving patientcarecomplementedtheSisters'devotion.Thelate Dr. Charles Jaimet is a good example. He revealed his findings on the clinical use of radioactiveisotopesata Medical AdvisoryCommitteemeeting onlday8,1950, two years after the Canadian government released radio-isotopes for medical research. The radio-isotope, an atom which grvesoff radiation, could be administered to a patient either orally or by injection.The radiation given off, while lessthan that of an ordinary dental X-ray, was enough to be tracked by a highly sensitive measuring device called a scintillation detector. This instrument detected where the isotopes ended up and whether they concentrated in one particular spot. Internal bleeding or kidney diseasecould more easily be diagnosed this way. Because certain isotopes concentrated in certain areas of the body, this was a method of treatment, for example, of an over-active thyroid gland. Iodine also concentratesin the thyroid. A precisedose of radio-isotopes of iodine could be gtven to the patient. They would go straight to the gland, bombard it with radiation, kill off some of its cells and thereby reduce its activity. Dr. ]aimet's years of researchinto this valuable diagnostic tool resulted in a uniqtre link with McMaster University. In 1958,Dr. ]aimet and Dr' H. Thode (director of the medical research department at the university and international authority on nuclear physics and atomic energy) establishedthe most modern isotope laboratory in Canadaat St. Joseph's.The lab functioned as a department, with the official approval of Atomic Energy of Canada.Dr. ]aimet, one of the first physicians in Canada certified to administer radioactive materials to patients, heiped forge a link between fundamental reearch being carried out a-t the university and its practical application of testsand treatmentsat the hospital ft" result was that two labs were working on individual medical cases.Other hospitals had set up similar clinics but St.Josepn"shad the distinction of being the first to engagein research. The hospital made medical history when it named to its medical staff three nuclear scientists from the university who were on equal footing with members holding medical degrees.They were physicist Dr. M. Johns;biologist Dr. P. Nace 57 SisterMery Grcce Staens sercedas hospital aatminisfiator from 7W to 7960end from 7!N3 to 7970. Sisterloan O'Sullioanbids farcutell to Dr. Robert Hagga4 atho retbed as Aief of Pathology on f anuary 78, 7985.Dr. Haggar uorkcd at the hospital lor almost 28 years. and chemist Dr. R. Tomlinson. These men joined Dr. Jaimetand Dr. RobertHaggar, chief of pathology at St. ]oseph's on an advisory board governing the new department. Commenting on this dramatic departure from medical traditions, Dr. Jaimet said, '1 considerit of tremendousimportance.The fate of medicineis intimately bound up with people who are not MDs."ln emphasizing the significanceof bringing together scientistsof differing backgrounds, Dr. Tomlinson added, "I do not appreciate the problems of the medical professionand they do not appreciatethe tools available to them. Through mutual co-opera- tion, the bringing together of different disciplines, problems that lookcomplicated to one seemquite simple to another." A Hamilton Spectatorreporter made an interesting prediction in 196,3on the McMaster-St. Joseph's relationship when he said: "Such recognition was a notable achievement in a city which,lacking a medical school,does not qualify in the strictest senseas a medical researchcentreat all. In fact, if Hamilton ever does become one, the link between hospital and university for radio-isotoperesearchmay prove to be a vital factor in its creation." In themidst of thesedevelopmentsa change of administration took place at St. Joseph's. The reins of administration were handed over without fanfare and if the Sistersare said to have a managementpolicy at all, it would be the maxim "Desire that others think little of you and much of everyoneelse;be grieved that youshould be esteemedbut happy that others be esteemed." Sister Mury Grace Stevensfirst assumed theroleof administratorin 1954.Twentyyears earlier she had graduated from the troipitat's schoolof nursing. At graduation, shereceived the prize for preventive medicine. If ever a personfound the limelight a penance,it is this woman with the genteel demeanour. Behind an expressionthat is by turns wry or mirthful, she has a mind that worked on some of the most advancedideas ever introduced to hospital management.Mention her name to those who worked with her and the responsegiven in reverentialtonesrangesfrom "fair-minded" to "a visiotrrd\", "a brilliant administrator/' and "a woman aheadof her time". Long after her retirement, she could attend a hospital 58 function and receive a standing ovation just for entering the room. '?.eallp why all the fuss?" she might ask in her warm voice. Sister Mury Grace always achieved her goals, often taking the staff by surprise as she did so. One afternoon in 1952 Sister Cleophas Fischerstepped out to a dentist appointment. In that brief absence, she was appointed Ontario's first hospital press officer by Sister Mary Grace.In those days reporters were not satisfied with the way they were receiving news, recalls Sister Cleophas: They would get one personand the next time they called, they would get another. There was no continuity. That day, Sister Mury Grace chaired a meeting and when I refurned, she said to me You have to look after the press.'Thatmeantall radio, television, and newspaper people. If I had been present I never would have approved it. Anyway,I had extension307 in the business office and that becamethe pressnumber. If we had a feature we would call all of them and give them a deadline date when they could release. Seven days a week, we covered the press desk from 8 a.m.to 10p.m. I rememberone night when I was ready for bed and an emergency came in. I went down in my black housecoat and bare feet, carrying my This chapel openeilin7955.The formet chapelutas conoertedinto the departmentof physiotherapy. shoes.I figured they would not know the difference (between the black habit and the black housecoat). Sister Cleophas, awarded an honourary life membership in the C-anadianfiress Club, set the standards for successful media relations. Essentially they are the same ones followed today by the hospital's public relations Having enteredthe convent rn 1922,Sister department. Cleophashad long honoured her vow of obeThe Sisters were also frequently blessed dience. In her newly prescribed role, she went with lay staff whose dedication to the hospital about setting up the media deskbased on the paralleled their own. Dr. Stan Hudecki repre principle that honestp kindness and consid- sentedthat breed.Shortly after his arrival at St. erationinher dealingswouldmean the hospi- foseph's,his name cropped up at the April 11, tal neednot fear inadequateor adversepublic- 1950,Medical Advisory Committee meeting. ity. She also credited her successto divine It did not take long for hirn to distinguish inspiration: himself among his colleagues. From then on his attendance was regular and his concern I had two brothers in the newspersistenton a far-ranging number of issues. paper business in New York. The minutes show that nothing escapedthe One worked for the Nao York scopeof his interest - from carcinomaof the Posf,but that did not help me. breastto intravenous use and abuseof saline. So I phoned Mr. Smitb busiAs early as 1952he suggestedthat resuscitaness editor at The Spectatorto tion traysbemaintained in the operatingrooms ask him how to start. He told at all times,and that provisions be put in place me to draw up a form, so I did. so that the hospital could meet a wide'scale Then I wrote to the Chicago disaster if necessary.It was almost 10 years, ReferenceLibrary. I guessthe however, before theseideas were instituted. Lord inspired me becausethey Eventuallp he becamechief of orthopedic told me they had a literature kit surgery and assistanthead of surgery.In 1980, on hospital pressrelations that putting medicine on hold, he entered politics I could borrow for 30 days. I and served four years as Liberal Member of took notes from this and sent Parliament for Hamilton-West. As a member them backfor constructivecritiof various committees he delved into issues cism. They made two or three from health, welfare and social affairs to nalittle changesand asked me if tional defenceand veterans'affairs.ln hishome they could publish my article in communitp Dr. Hudecki displayed the same Hospital Progress(which was commitment to the Hamilton Medical Legal published in St. Louis, MisSociety, Physicians for Life and the Rygiel souri), for circulation in CanHome, an institution for the mentally handiada and the U.S.I did not object capped. Many such men and women, both becauseI appreciatedtheir help. insideandoutsidethe medicalprofession,have aided the goals of the Sistersof St. joseph. By the end of the 1950s,alarmed at the critical, city-wide shortage of patient accommodation, St.joseph's and other city hospitals prepared to increase the number of beds in each institution. Throughout the decade the hospital managed to maintain its fullyaccredited status. In1952, the Royal College of Physicians and Surgeonsapproved St.Joseph'sfor post-graduate study in pathology and anesthesia.Three years later the joint Commission on Accreditation of Hospitals* granted St. Joseph'sthe standing of full accreditation.An all{anadian program of accreditationbegan in 1959under the direction of Dr. E. Kirk Lyon of Leamington, Ontario. The structure, organization and facilitie of a hospital determine its acceptability for accreditation;the degreeto which thesethree factors have been developed in hospitals is consideredto be an index to theimprovement in medical care. Dr. Lyoru chairman of the CanadianCommission on Hospital Accreditation, stated:"It is the belief of the joint commission that this improvement in the quality of medicalcarecanbestbebrought aboutthrough self-government and self-evaluation of the medical staff of each hospital. Accreditation then stands between the hospital and its medical staff and the public; and vouchesthat its staff, havingvoluntarilyasked for a survep a third party has found that quality of medical care meets adequatestandards." None of this came as a surprise to Dr. Herbert Sullivan, Sr., +The Joint Commission on Accreditation was comprised of the American College of Physicians, the American College of Surgeons,the American Hospital Associatiorl theAmerican Medical Association and the Canadian Medical Association. Joan Paterson arrived at St. Joseph's from Scotland in 1950.She worked in the physiotherapy department for 30 years before retiring. She remembers Sister Mu.y Grace with esteemand affection: One winter Sister Mary Grace went on a sleigh ride with some of the other Sisters.Sheaccidentally fell and iniured her lnee which reqqired a cast. After it was put on, she summoned me to the nunnery, asIcalledit,and asked me to bring a heat lu*p. I knew she wanted the lamp to dry thecast.Whenl told herl would not do it becausethe cast would crack if it dried too quickly, she was very co-operative. Within a few days, she suffered a strain to the leg in the castand neededphysiotherapy. She arranged to do her physio exercisesat 7:30a.m. and was an excellent,conscientiouspatient. After she finished her exercises she would tidy the bed. A few weeksbeforeEasterthe castcameoff and she told me I had to gether kneelingby Easter. That was her goal. I consultedSisterMary Grace on all the big decisions in my life. You alwaysknew whereyou stood with her.When my family cameto visit I always took them to meet her. Marguerite Reding graduated from St.josep-h's nursing school in fgAg. After graduation she supervisedthe pediatric wardanddid private duty nursing for a time. On ]anuary 13,19t49 she entered the Congregation of the Sistersof St. Joseph and took the name Sister Ma+ Austin. Her friends fromnursingschool wCre amazedat herdecision: People asked me how I could enter the convent with Sister Mary Grace. They wanted to lnow whatl would do if I had to live in the same house with her. You see,Sister Mary Grace was one of our instnrctore in nursing schooland I did not like her very much. I thought she was too strict. I resentedauthority. One day, I wrote a letter of complaintabouther and showed it to my mother, who promptly tore it up. Sister Mary Austin, who laughs now at her youthful stubbornness,said that shortly afterward, her opinion of Sister Mary Grace tumed to admiration: She has been a tremendous friend of mine. She would help you and stand up for you without any fanfare about it. As an administrator, she was very forward-thinking. There's no doubt in my mind that Sister Mary Grace has to be the most 6l Today Sistcr Mary Austin Reding uo*s information ilesk at the hospital. on tle fantastic person in our corrununity in the field of health care. In the early '60s, Sister Mary Austin attended a meeting with Sisterlvlary Graceand Mr. Pigott, to discuss plans for the new Fontbonne nurses/ residence. Mr. Pigott explained that the Sisterscould save money by not putting a sink in each student's room. '1 remember Sister lvlary Grace pounded her fist on the table and said, Mr. Pigott, we are not going backward. We are going forward. We have had sinks in the nurses' rooms since Undennount was buitt in 19221'u Theresidencewas laterbuilt with a sinkin everyrooilL + who in 1923had recognizedthe importance of that third-party evaluation. But despite the endorsementof the lofty college, something troubled members of the medical staff throughout the 1950s.Some of the cardinal rules of accreditationwere being violated, including the protocol outlined to staff decadesearlier which statedthat all doctors were to carefully document diagnoses prior to surgery, record details of eachoperation performed and complete clinical records of all patients. In 1953,at the January 12 meeting, it was brought to the staff's attention that a patient had beenin the hospital for two monthsand no history had been written. In additiory only sketchy notes had been made on patients' progress/which prompted one doctor to caution that "a dim view would be taken of this delinquency'' by the college. Again in 1954,doctors were urged to keep hospital recordsup to date and make sure old charts were completed. Twice more in 1955 came reminders that unsatisfactory charting methods were not only unacceptable,but damaged the quality of patient care.Progress in solving this dilemma was minimal due perhaps to the fact that it was almost impossible to monitor the many doctors who had admitting privileges at St. ]oseph'sas well as cross-appointmentswith other city hospitals. Doctors in generalstill lacked an appreciation of their accountability to the public. By 1958,however,asthe hospitalwas about to enter the most robust phaseof growth in its 70-year history, it again received approved status. In fact, the Joint Commission recommended that an expansionprogram should be expedited to relieve the overcrowded hospital. The Commission conunendedSt. ]oseph's in its report, "for maintaining standards de. serving of accreditation and for its constant effort to improve the quality of patient care." But the report also contained a significant reproach - patients' current records mwt be completedwithin 24to48 hours of admission. Admonishment aside, a hospital spokesperson likened the approval to a "sterling mark on silver;" a guaranteethat the hospital measured up to high standards of operation in every major respect. At this stage of development the question of qualitycontrolas it pertained to patient care becamecrucial. Beforethe new surgical building opened in1962, asystemof checksand balanceshad to be firmly in place that required all physicians to be fully accountable for every procedure a patient underwent. Without exception work-ups, histories, physical examinations and consultatioru had to be properly charted. By 1959,St. Joseph'sstood poised to forever rid itself of any hint of an image as a mediocre, unsophisticated bread-and-butter hospital. In her typically direct style, Sister Mary Grace took an unprecedentedstep in the history of Canadian Catholic hospitals when she detectedthat the "sterling silver" showedsigns of tarnishing. Feeling that the order to shape up must be issued by someone other than a Sister- preferably by a strong medical person - she simply advertised that the position of medical director was open at St. Joseph's.The successfulapplicant would be the first medical director in any of the 285Catholic hospitals in Canada at the time. "We were progressing. 62 With this beautiful new hospital planned, I wanted everything about it, including its nunagement, to be perfmt," she recalls. The 1950swere literally, and figurativelp a period of grace for those medical staff members who filed incomplete patient records. The man Sister Mary Grace hired to lower the boom on slackadherenceto protocol would propel St. joseph's from its uncoordinated adolescent stage to full-fledged adult status.He would also restorethe real meaning of accreditation. Chapter Eight CHANGING OFTHE GUARD Dr. Kenneth J. Williams, a risk-taker who refused to run from controversy, answered SisterMary Grace'sad (and her prayers,more than likely) for a medical director. He also a crusader'szealthat complemented possessed her agenda for change. At the time, he was restlessin his iob as associateexecutivedirector at the Royal Alexandra Hospital in Edmonton, Alberta, and ready to embracea new challenge.He vividly remembershis first visit to St.Joseph'son a late spring day in 1960.The minutes recorded his brief introduction to a meeting of the Medical Advisory Committee on June 7 as ".. . Dr. Williams from Edmonton who is here for the purpose of consideringthe position of Medical Director.Dr. Williamsholds a Master'sdegree in hospital administration and public health from Yale University." If thatfirst meetinghad to bethedetermining factor in taking the job, he says it would have turned him against the hospital. "The group was affable but they were not charged up with balls of fire. In those days, meetings were short.Coffeeand finger sandwicheswere served, a few appointments were announced and then they went home," recalls Dr. Williams. The businessdiscussedat that meeting covered three scant pages and did liftle to 'T.eview, analysis and evaluimpress him. ation of clinical work, be it good, bad or indifferent, never entered the conversation." Left to ight: Dr. William Goldberg Dn Kenteth l. Williams, Dr. Gordon Cameron 63 Dr. Williams saw an opportunity for reform and acceptedthe job. One of his initial tasks,he knew, would be to explain how and why a medical director/s efforts could bring about significant improvements in the hospital. The medical director, he told them, treads a fine line: axe, taking care that the fallen part did not take you with it. You also had to be certain you did not chop your rope. There were no secondchances. Thechancesof making it were not always in your favour. It was a rough, tough, hard-fighting life with a lot of risk to it. Accident compensationwas not good in those days. Pensions were unheard of in the woods. While not a member of the medical staff, he mwt be active in the affairs of the staff. Although he himself is not a practising physiciarUhe must know how physicians are practising. Without telling physicians how to practise medicine he must tell them how medicine is practised in that particular hospital. In essence,the role of medical director is that of coordinator, catalyst,liaison officer, and not infrequently the conscienceof the medical staff. His multi-faceted role is probably best summed up in a tenn used by the behavioural scientists - that of change agent. a supportive crew working with him and accept the hazards the pb entailed: As one of the Sisters' maxims states, Dr. Willias6 was, in effect, asking the medical staff to, "Rrt off entirely the old spirit and put on the new." In making this request, he was prepared to stand alone in the face of criticism. He discovered that a job he once had in a r.c. logging camp and the task of medical director shared common requirements - he had to know exactly what he was doing, have I have always mjoyed high-risk endeavours.As a high-rigger,l had to climb up a 150-to 200foot tree with belt and spurs, taking off the limbs as I went. Between 20and 30feet from the top, where the diameter measured about 20 inches, you chopped off the tree with an Dr. Kmneth l. Williams, MedicalDirector, August 15, 7%i0to Mctch20,7965, & Dr. Williams had just begun to considerhis job in the woods as one with a bleak future when he suffered a serious head injury. 'The i"j"ty gave me quite of bit of time to think. Thenfour very closebuddies put up the money for me to get started in medicine- rather, first I had to go back to high school.They continued to support me after I was married, which was just when I got acceptedinto medical school." He received his u.p. degreefrom the University of Manitoba. After eight years of private practice in his native British Columbia, Dr. Williams entered the maste/s program in hospital administration and public health at Yale University and graduated in 1959.His ambitious personalagendasynchronizedwell with eventsat St. joseph's. SisterMary Gracewanted a hospital committed to quality patient care and that is exactly what he promised to deliver. The old guard of faithful doctors would have to yield to a phalanx of men with a different strategy for negotiating the hospital's future. In keeping with previous battles from which the hospital had emergedtriumphant, there would be some resistance, a prospect which had the effect of stimulating rather than overwhelming the leader whom Sister Mary Gracehfued to champion her cause.She also, as it turned out, had a surprise in store for him. Dr. Williams and his wife Joy bought a house on Aberdeen Avenue in the cit/s southwest end and moved in with their five children. His appointment was announced on August 15,19ffi. Less than two weeks later, SisterMary Gracepausedbriefly at the door of his office and told him she was leaving. "I thought she was going out for the day. Shebarely stopped in the processas she sai4 'Im leaving. I'm going to Kitchener. Everything will be okay.' I felt the rug had been pulled out from under me. Suddenly, my patron saint was no longer the queen bee. My power basehad dissolved overnight. I subsequently learned that she knew of her posting when she interviewed me, yet said nothing. Somemonths later when we met again I asked her about it and she said the transfer was providentialand shedid not want to loseme." In fact, Sister Mary Grace had been appointed clinical instructor and supervisor of pediatrics at St. Mar/s in Kitchener and had no choicein the matter. Sheknew what needed to be done in Hamilton and simply did what was necessarybefore her departure. Dr. Williams'initial concernwas to ensure that the hospital's almost tt00physicians were accountablefor their actions and that controls were consistently applied. The Medical Advisory Committee (ruec) met on October 4, six weeks after his arrival. The minutes of that meeting reveal complete details of businessrecorded on five pages of single-spacedtype. Committees were formed - for credentials, anesthesia,interns, medical records, tissue, patient admission and discharge- which would emanate from and report back to the monthly Medical Advisory Committee meetings. That day in October, with Dr. Williams presiding, committee members took their first steps in assessingdata on the activities of each hospital department. Some problems arose. For example, the medical records committee'viewed $rith dismay and shock the number of incomplete charts." The admission and discharge committee emphasized the failure of physicians to write progressnotes on patients'records and pointed out that this hamperedthecommittee's efforts. Dr. Williams listened.He did not like everything he heard. He waited until the end of the meeting to voice his displeasure. He re-emphasizedsimple basicsof patient safety - the writing of medical records, preoperative work-ups, pre'surgical diagnoses, completely documented histories and physical examinationsof all patientsin the hospital. He warned the physicians that failure to fulfil theseobligations could result in the hospital's loss of accreditation.He reminded them that the Medical Advisory Committee could not adequately review the clinical work of the hospital if it did not receivemonthly reports from eachdeparhnent. Finally, he suggestedthat one way to accomplish their goal was to defer surgery on any patient, emergenciesexcluded, until the physician had written the necessaryrecords. Some doctors resented the new process becausethey felt it amounted to peering over their colleagues' shoulders. "Those who re sisted did not canseme to lose sleep.I knew Dr. S. E. (ted) O'Bdcn uitncs*d of ageuniletDr. Williams. the hospital's comitg what had to be done and that was it,' Dr. Williams says."I cameunder criticism for this approach,but I never socializedwith the staff. I refused to belong to the medical society." He spent long hours pursuing any hint of on a case'by-casebasis."I did not carelessness work alone," Dr. Williams notes."I had the unfailing support of sometop-calibre physicians. Thoseindividuals included Gordon Cameron, Bilt Goldberg, Stan Hudecki, Ken Ingham, Al Johnson,Ted C/Brien, Iim Osbaldeston,Iack Walker and Bill Walsh, among others. They never doubted their ethical obligations and their collective social responsibilities to the public. They knew the scoreand did not mind being in the vanguard of social action." Even in retirement, Dr. Williams' voice is gruff with the authority he wielded throughout his career.The years have not diminished his enthusiasm for the topic of physicians' accountability to the public: I did not invent thesestandards. These were time-honoured, nationally recognized minimal standards initiated by the medical profession.They were long acceptedboth in theUnited Statesand Canadaasnecessary for the furtherance of patient safety. If you do not maintain proper and complete records then you cannot begin to carry out a retrospective review of the medicalcarebeing rendered by physicians. If a surgeon fails to commit a pre-operative diagnosis for opening up a patient's abdomen, for example, then there can be no post-operative diagnosis or appraisal of the surgeon's diagnostic acumen. Tremendous advancesin the technologyof medicinebrought parallel and exactingdemands on the structure, organization and function of all hospitals. The scienceof managementin hospitals, to say nothing of the medical staI f or ganization,was accessoryto any activity that would mar its reputation or erode the public's trust. "Proper medical recordsconstitute the essenceof quality control of medical care in the hospital setting. Not just for surgery, but for the whole field of medical care," Dr. Williams maintains. Dr. jim Osbaldestonviewed the hiring of a medical director as St. ]oseph's turning point. "It wasa strokeof geniw on SisterMary Grace's part. He was the first medical director in any Canadian Catholic hospital - that is, medical director in the modern senseof the term." Dr. Ted O'Brien, who joined the department of surgery in 1954,witnessedSt.Joseph's coming of age under Dr. Williams. "Our hospitalwasno worsethan any othersatthattime, but we did not have the committee structure and organization. Ken stood the place on end, making a few enemies in the process,but he did a much-needed job. As a result he impactedon Hamiltonls medical community. We grew up." Dr. Williams recognizedthat the improvements would not happen overnight. But when it became obvious that some doctors continued to file incomplete charts, he exercisedthe unpleasant option of cancelling surgery. One morning he issued the order "no physical examination on the charts, no operation" to the offending snrgeons.Scalpelswere replaced by pens as physicians returned to their offices Stringent controls and staff organization to complete the paperwork. Dr. Alan Lane,chief of surgery at the time, would also prevent suchproblemsasunnecessary surgery or fee'splitting - a situation in recalls the controversy when Dr. Witliams whicha patient is referredto thespecialistwho loomed in the operating room door to prove he meant business: gives the largest kick-back Monitoring the detailed recordsprovided When Kencamealonghejolted the bestsafeguardagainstSt.Joseph'sbeing an everything up. He opened my conspicuousby its absence.But the pressureswere building up on hospitalsand medicalstaffs. The American Joint Commission on Accreditation of Hospitals (which included Canadian hospitals), the American College of Swgeons and later on the Canadian Council on Hospital Accreditation were demanding formal staff organization with objective'oriented committee structure alongside in-depth critical analysis of hospital medical practice.Concommitantly, the demands for public accountability were building up on hospitals. Coping with all thesemoving social forces bearing down on you was not easy,particularly for the religious women. Lefs face it, they did not enter the convent to becomeengagedin conflict. It is to Sister Mary Grace'scredit that shewas able to seethe big picture and realize that a really major re-organization had to occur at St. joseph's. 66 eyes to the imPortance of the administrative side.He insisted that a pre-operativePhYsicalbe written on a Patient bY the operating surgeon.Someof the surgeons were slow about coming around, so one morning he simply cancelled every operation that did not have notes written out. Of course,this causeda great furor.In the middle of it all he came up to the surgeon's lounge,satdownandhad a cuP of coffee. Everyone was complaining but he just took it all in. He did not try to hide. He had given them amPlewarning and they had not comPlied.The next day, pre-oPerative histories were written. Soft-spoken Sister Mary Daniel Weadick an operating room nurse, also found herself caughtin thecross-firethat morning. The infuriated doctors formed one side of the battle line. Dr. Williams formed the other side. She worried about the impact of the chaoson her patients and could seethat Dr. Williams was not prepared to back down: Wewerehaving a Problemwith incomplete historiesand it was always the same offenders. When Dr. Williams lowered the boom, it meant the Patients were penalized in a sense because their surgery was Dt. A, Lane rcmembersthe struggle to get prc-opetatioe historics utrittet. cancelled and it was not their fault. I did not seeit at the time asbeing a safeguardfor the Patients. I was in turmoil because I had the doctors on one side and Dr. Williams on the other. He would not relax at all. He wassteadfastand firm. He came on very strongbut he was right. He did a great deal for Patient safetv. 67 Dr. Williams considered a system of accountability within the hospital as the crucial first item on his agenda. Once this groundwork had been successfully established St. Joseph'sstood poised to enterphasetwo the ProfessionalActivity Study, which measured the hospital's willingness and ability to compare its performance with that of other hospiials participating in the study. Valuable information on the hospitalls practicesand procedures was gained by the reams of data compiled from the existing medical recordsby the medical record librarian. Dr. Williams was not satisfied with the hospital simply asserting that it gave good care; he wanted to be able to measure it. pes, conductedby the Commission on Professional and Hospital Activities in Ann Arbor, Michigan, provided the yardstick The commission, a non-profit medical researchorganization sponsored by the American College of Surgeons,American Collegeof Physicians,AmeriianHospitalAssociation andthe Southwestern Michigan Hospital Council, was developed with grants from the Kellogg Foundation. At the same time, the staff was also installing a data storageandretrievalsystemknown as the Medical Audit Plan (uar). This was a sophisticated,computerized American medicai information system which stored data and furnished monthly read-outs by internist, surgeon,department and diagnosticcategory. At i glance,they gave the hospital a profile of a physician's patterns of practice and highlighted any deviations from what was considered standard Procedure. This orderly presentation of variations stimulatedthe medical staffto investigatethem, discussthem and judge them with the goal of continual self-improvement. It allowed the medical recordsdepartment to maintain comprehensiveclinical data on diseaseand operation records that were not possibleunder former reporting procedures. Accessto that information had to be easv. 'T..lotonly did we have that cadreof physicians who saw all this as a vital tool for continuing medical education, but we were blessed with SisterAngela Busch,one of the bestregistered medical record librarians I have ever worked with anywhere," Dr. Williams recalls. "br effect,shewasoneof the ownersof thathospital. Sheknew its objectiveswould be erodedwithout proper controls and the critical review, analysisand evaluationof clinical work, which was the raisond'etre of a medical staff organization. She was indispensable." Preparing the data for analysiswas a time. consuming manual irb, according to Dr. Iim Osbaldeston.'The way we used to do it in the early days was amusing. Ken and I would sit for hours, drawing up patient profiles so that they could be worked on the computer. They were very rudimentary audits which we would laugh at today," he said. Dr. Williams alsocalledon two friends, Dr. Iaurie Chute and John T. Law from The Hospital for Sick Children in Toronto, to help him to explain the importance of the professional activity study to staff: ]ohn was the head man in administration. Laurie was a professor of @iatrics at the University of Toronto and chief of pediatrics at SickChildrens'. I asked them to come to St. ]oseph's to an introductory sessionwhen Dr. Vergil N. Slee, director of the Commission on Professionaland Hospital Activities, met with our staff. Laurie was a short, slim, freckle-faced man. I can still hear him telling the staff in his low-key but impressive voice, that physicians had to be prepared to have their work come under public scrutiny and that it was the governing board of the hospital who was in charge. that it had to be anonymous. We managed to adhere to that request and he supported that program to the fune of severalthousand more dollars." Next, with the simplification of data retrieval from medical records,facetsof practice within the hospital - the utilization of blood transfusionsor antibiotics,for example- could be quickly and easily audited by a committee. The committee could then decide on standards to apply, or determine the activities in need of attention and recommend educational programs. The benefitsof Dr. Williams' efforts carried positive long-term consequences,not just for St. joseph's, but for the community it Becausethe cost of PAS was not reim- served. bursed or shared under any of the provincial Once his goals had been successfullyathospital serviceplans at the time, other hospi- tained, Dr. Williams, as usual, decided the tals were slower to join. Dr. Williams, with his time had come to move on to new challenges. eye trained on excellence,saw to it that St. On ]anuary 5,"1.965, he informed the Medical overcame question the funding. of Advisory Committee that he was resigning to ]oseph's Dr. Williams organized a committee to accepta position at a Detroit hospital. examineand report on every medical activity Dr. jim Osbaldeston, MAc chairman, exthat took place in the hospital. "lJnderstand- pressed sincere appreciation to Dr. Williams ablp there was resistanceand I was told there for his "expert professionalguidance,untiring could be no funds for suchprograms," he said. efforts and personal integrity" during his five His determination was rewarded. The years as medical director. women's auxiliary deservescredit for contribMinutes of that meeting record that Dr. uting funds that enabled the hospital to par- William Goldberg commented, "Dr. Williams ticipate in the professional activity study. "I hasdone more than any other man to raisethe rememberSisterAngela eying it wasn't luck, level of medicalcarein the history of medicine it was Providence," Williams said. in Hamilton." Encouragementalsocamein the form of an The committee asked Dr. Williams to preunexpectedvisit one day from Bishop Joseph pare a critical appraisal of the hospital's mediRyan."He had droppd in to let me know that cal affairs and to make recommendationsfor if I neededany help to be sure to call on him," improvements as well as a plan for continued Dr. Williams said. "So I told him about my progressive development. problem regarding funding and before he left Dr. I^aurie Chute and Mr. ]ohn Law were I had a chequefor $5,000with the only caveat invited to Dr. Williams' farewell dinner. Al- thoughmany yearshave passed,Dr. Williams still recalls with pride the most memorable accolade bestowed that evening: "After the dinner, john said to the assembledgroup that he had never seena group ofdoctors as el(pe. rienced, (vis-i-vis hospital affairs) and as knowledgeable about their collective responsibility to the public. ]ohn was never known to waste words." St. loseph's 'change agenf agreed with him. Dr. Williams had arrived at St. Joseph's witha blueprint forrevision and he feltcertain that, if the necessarychanges couldbe madein joseph's time, St. would shed its status as a rather ordinary community hospital providing general services and become a sophisticated teaching hospital with specialtiesof its own. The accomplishments of this five-year period representedSt.]osepn"sfi nal coming of age. To this day Dr. Witlla6s gives all the credit to the staff, both lay and religious, who hadthe courageto set an exampleof how firstrate health care could be delivered to a community. 69 Chapter Nine COMINGOFAGE If pr. Williams seemed impatient to execute his program of improvement, he had a good reason.His aggressivestyle was labelled "too swift and too brutal" by those who initially opposed him, but he felt no guilt and offered no apologies.St. Joseph'sfuture development was at stake.Dr. Williams recalled: In the late 1940sor early'50s I knew a prominent pediatrician, Dr. Jack McCreary at the Hospital for Sick Children in Toronto, who went on to be come one of Canada's outstanding medical statesmen and administrators. In 1960,shortly after I arrived in Hamilton from Edmonton, ]ack called and told me he had iust been engaged by the Ontario government as a consultant to build and organizea new medical school in Hamilton. It had been rumoured for years but was never more than that. The school had not yet been publicly announced. Dr. Williams learned that a university hospital was also planned, but that it would be another three or four years before building commenced: Basically, Jack told me that I had a beautiful opportunity to proceed to re-organize St. Joseph's,preparatory to it taking its placeas the number-one teaching hospital in Hamilton. He kept me abreastof the progress and some of his ideas. I served as a critic from time to time for him. I did tell Bishop Ryan, who was very supportive. Eventually, I shared our target with the staff, but at the start I could not do so. A happy tio at the opening of the rcgional hemodielysis unit in 7967.Dr. Galloutay, medical ditector, utith nutsesPlryllis Morelli (left) anil Loflq Mattheu)s. 70 Once this objectivewas revealed,an eager medical staff embracedthe opportunity to set a standard of upgraded health care for the community through the steps taken at St. Joseph's.Dr. Williams continued: Without worrying about modesty, I would say that there is no question that St. Joe's assumed a leadershiprole. There is just one qualification - it was not my doing. It was strictly a joint effort with a group of physicians who understood their collective social responsibility to the public. I stress that becausenot too often in a long careerdid I come across such a group of physicians who reflectedthat public trust. A significant development due to St. ]oseph'sreorganization- regionalizedhealthcareservices- resulted from a Medical Advi sory Committee meeting in January, 1965. Near the close of the meeting, discussion centred on the fact that, while St.Joseph'swas proposing expansion of its own maternity wing, one of the other city hospitals was also set to open a maternity service.The committee expressedconcern about maintaining the quality of obstetricalservicein the city. Dr. Iim Osbaldeston recalled that in this discussion Dr. Ken Ingham posd the question: "Isn't it too bad that we do not have some kind of co-ordination among the hospi tab?" On a motion made and seconded,they Mothet Alacoque Hayes initiateil discttssion on regionalizcd *nice s amoagho spitals. Dt. lames D. Galloutay, Medical Directot 7965- 7970, Exeattioe Dbector 7970- 7979 voted to "recommend to the administration and governing board the need for a master plan both with respect to programming and facilities." This would be particularly important when the medical school arrived because its academic programs would improve patient servicesin every hospital in the city. Dr. Osbaldestonpresentedthe suggestion to establisha hospitalcouncil to Mother Alacoque, who readily acceptedit. Lessthan three weekslater she and SisterMary Graceinvited representativesfrom the other city hospitals to a meeting in St. joseph's board room at 4 p.m. on February 1,1965. Presentat this meeting were Rev. Mother Alacoque, chairperson;SisterMary Grace;Dr. Kenneth Williams; Dr. H.E. Appleyard from the Hamilton GeneralHospitaL Dr. H.T. Ewart, Medical Superintendent of the Hamilton Health Association;Mr. A.B. McFarlane,Chairman of the Board of Governors, Hamilton Civic Hospitals; Mr. W. O'Neill, Administra- 'll tor of JosephBrant Hospital, Burlington; and Mr. T.A. Rice, President of the Hamilton Health Association. Dr. Williams explained that, although a university medical rhool/hospital complex was on the horizon, there were other reasons for Hamilton hospitals to get together. They all needed joint programming for bed distribution and to avoid duplication in use of medical and technological skills, medical equipment and function. They also needed to reduce the financial burdens resulting from such duplication. He emphasizedthat hospitals must view themselves as public utilities, offering Hamilton citizensflexible and comprehensivemedical service.He believed it would be unnecessarily expensiveand impractical for eachhospital in the community to try to give this kind of service on a separatebasis. While it was understandable that each hospital would want to improve and expand its services with the advent of a university medical complex, he noted, unless there were co-operation and planning on an area basis they would find themselvesbeing organized by another, perhaps higher, authority altogether. At the conclusionof the meeting, all were in agreementthat the hospitals should work closely together to organize their specialties. The group continued to hold regular meetings to determine eachhospital's servicesand areas of expertise which could complement the new medical rhool's educationalcurriculum. Their aim was to provide the optimum in health care, health education and health researchat a reasonablecost.The community of Hamilton-Wentworth stood to be the main beneficiary of this co-ordination of health care services. Thus, from a comment of concern by one physician at St. Joseph's and the enthusiastic co-operation of many others, the seed was planted for what became officiatly known as the Hamilton-Wentworth District Health Council. Dr. Williams was pleased with the great strides made by St. |oseph's. "Although I was leaving,I knew St. ]oe's had the horsesto pull the load. I well remember how proud our Medical Advisory Committee was to be leading the way." The reforms brought about by Dr. Williams would be further strengthened by his successor,Dr. ]ames D. Gallowap who would introduce many changesof his own. In September,1965,Dr. Galloway left his position as comnurnding officer of the t25bed Canadhn ForcesHospital in Kingston to become the new medical director at St. Joseph's.Three years earlier he had earned a diploma in hospital administration at the 'Ioronto. ln 7970,Dr. Galloway University of becamethe hospitals first lay executivedirector. He emphasizeda team approach to hospital management. Although he is still more comfortable giving rather than taking credit, the fact remains that the role he played 25 years ago is central to the hospital's status today. Dr. Galloway strengthened the hospital organization and management by recmiting skilled executives in such areas as finance, administration and business. He thought it was important that employees felt they were an integral part of the organization. He intro- duced ideas that are still active today such as the Quarter Century Club, a social club and recognition for years of service. "I wanted all staff to feel part of a team - that it was our hospital," Dr. Galloway said. Under Dr. Gallowa/s direction, the hospital gained regional distinction and assumed responsibility for a chest and allergy unit, kidney transplants and nephrology, toxicology, emergency psychiatry, head and neck surgery as well as a psychiatric liaison unit. "\rVedeveloped rational health care programs through the health council so that hospitals were no longerin competitionwith eachother. Mother Alacoque really deserves the credit for that " said Dr. Galloway. EXCEPTTONALCARE AT ST.IOSEPH'S It is, of course, the patients who benefit from the regional programs at St. ]oseph's as the following stories illustrate: Eight-month-old ]amie Weber pulls himself up onto the living room sofa in a struggle to stand on his chubby little legs.When he has accomplishedhis purpose, a merrysmile lights up his face.The look in his wide blue eyesis a mixture of wonder and pride, as if to say "See how cleverI am." Exceptfor a slight cough, he is the picture of health and alert intelligence.But this goodnatured little boy who was born on january 23,1989,to Gord and ]udy Weber of Oakville, suffers from asthma. Iudy, 33, said the family had started to adjust to the routine care of their new baby when ]amie came down with what appeared to be a sudden chest cold. '1 went back to work in mid-May. Jamie and his sister, Stacy, (, -J ;l h'e g nl 6S ts R F i(a itll os S: 3$ NF FS $T ?il iF F.F f 5.s s a q ss a Es S-'€ i€5 >d E' -J 5 -€ -.o s: * XE io' XF $g F* H ' - *€ s N Ys+ tsN \ F.S * FT s: g*n q{sN $ $..F =' ft *;' \' 3- s. (Dq b F SX |!o ! ! ((SF H5$ Ts3 $s \ o (! $ 66 {o L (^) G *s }U E.3 .gE laG i* FS. :\o 8$ nS BF 6.G (D: €F $F EE: were in day care. Everything was going well until one Wednesday night, when jamie de' veloped a fever and a cough. On Thursdap he was worse and by 1 p.m. on Friday, June 23, he had been admitted to the hospital in Oakville." When Gord,33, arrived at 5 p.m. that dap his infant son was in an oxygen tent. "He was hooked up to intravenous feeding and antibiotics. The only time he did not cough was when he was sleeping but a noisy room-mate kept jamie awake. He could not get any relief." On July 4, Jamiewas discharged from the hospital with four prescriptions for medications to help his breathing and clear up his cough. He had lost one pound. His skin was pale and he had dark circles under his eyes from lack of rest. His parents were disturbed becausehis condition did not appear to have improved. Gord and judy were both exhaustedfrom late nights spent at the hospital with their baby.Their daughter Stacyfelt neglected.judy had lost time from work. Their nerves were frayed and the frustration mounted that not enough was being done for their son. In a three-week period they had spent $500 on drugs that appeared to have little, if anp effect on his condition. Jamiecould not return to daycarebecause no one there could administer his medication. To make matters worse/ the daycare centre still had to be paid the $400monthly fee even though he did not attend. Fortunately judy's sister in Burlington, a registered nursing assistant, volunteered to care for Jamieuntil he could return to daycare. Iudy did not feel right unless she paid her sister too. "It was a no-win situation," says ]udy, who kept detailed notes on everything that happened throughout the family's ordeal. "On ]uly 20 Jamie had what I call an attack. He turned blue and could not breathe. We rushed him to the family doctor, who sent him home and told us to stop some of the medication. The next day I took jamie to the pediatrician. By that time I had lost any sense of diplomacy. We were angry that we had to take the initiative and demand an immediate referral to a specialisti Iudy recalls. The Webers were grven a choice - an eight-week wait for a Toronto specialist or a five-week wait for one in Flamilton. They chose the waiting list at the Firestone Chest and The opentngof the regioncl hemodialysisrrtt ir 7%7 - W to right: Bishop loseph F. Ryan' Mothet Alacoque Hayes, SisterMary GraceSteoens,Mattheut Dymond, Ontaio health ministct, and Dr. lanes Osbaldeston. '75 Allergy Unit at St. Joseph's. Within a week of the first visit, ]amie's evictedthe family cat and smoking is no longer On Monday, July Z4,ludy dropped ]amie cough was gone. Throughout the autumn he permitted in the house. "\Ne even had all the off at daycare and made the 75-minute drive had regular appointments and his improve- ducts cleaned," Gord laughs, as he bounces to her office in Brampton. '1 walked in the ment was steady. The Webers were advised his son on his knee. "jamie could not tell us door and the phone rang. The daycare called not to treat him as a sickly child. They are now how he felt but it must have been awful. But to say that he was far too sick to be there. I hopeful that asthma is a condition he may you know, he smiled through it all." turned around and went to pick him up," she well outgrow. Life has returned to normal in the Weber says. "When we got home I called Dr. As a precaution, they have temporarily household.Gord and Judy are grateful for the Newhouse, head of the Firestone Chest and AllergyUnit, and told him wecould not wait. Three days later we had an appointment." A resident physician examined jamie's ears/ nose and throat, listened to his lungs, recordedhis completehistory and relayed the information to Dr. Newhouse. 'nVhen Dr. Newhouse examined jamie, he told us right away that our son had asthma and it was out of control. We also found out that jamie had bronchitis, which had not clearedup from his stay in the hospital," Judy sys. "Dr. Newhouse increasedthe medication to four times as much as originally prescribed by the pediatrician and asked to seethe aerochamber we had beenusing to administer the medication." The Weberslearned that the aerochamber had been designed for an older child with stronger lungs. "Dr. Newhouse said that not only was it almost suffocating ]amie, but he basically was not getting any of the medication." judy recalls."Dr. Newhouse explained everything in terms we could understand and gave us a new aerochamber especially designed for infants under age one. 'tle was the first doctor I had talked to who was human with children. He was not so At the 1979opeaing of the Firestone Regional Chest anil Allergy Uait, Sister Marina Flaherty prqates to cat the reserved that he stayed behind his desk. He ribbon helil by Dr. Michael Newhouse as Bishop Paul Reiling (directly behind Dr. Neuhouse)anil SisterAnn played with Jamieand talked to him." Marchall (ilirectly behinil SisterMarina) look on. Dt. Michael Ne@house(ceatte), heail of the Firestone Regionel Chest cnd Alleryy Unit . 'nVe really feel that expertise at St. JosePh's. Jamiewas given exceptionalcare,"judy says. Dr. Michael Newhouse explains that asthma is an inflammatory condition of the airways that causesswelling, excessivesecretions and spasm of the smooth muscle in the airways. "This leads to symptoms such as a cough or wheeze, phlegm production, shortness of breath and chest tightness," he says' "Becauseof the inflammation, the airways are hyper-reactive or twitchy, so that almost anything will trigger a reaction- exercise,strong fumes such as paint, car exhaust or perfume, exposure to cold air or cigarette smoke." For some asthmatics, treatment begins with the removal of any identifiable underly- ing causessuch as things to which the child is allergic. If the source that initiates the asthma cannot be removed, the inflammation and 'Bronattackscanbe treatedwith medication. cho-dilators, administered by aerosol will open the airways by relieving the spasm,but it is even more important to get rid of the underlying inflammation that causesthe bronchospasm(narrowing of the air passagesdue to contraction of the musclelayer in the walls of the air passages),"Dr. Newhouse says."To control the inflammation, two groups of medication are used. Cromolyn may be glven by inhalation in mild asthma and corticosteroids may be given by injection, ingestion or inhalation in more severeasthma.The inhaled medication is directed straight to the air passage by means of an aerosol or fine spray of medication. This relieves the inflammation and keepsthe asthma under control as long as the medication continues to be taken. Becauseso little of the medication is needed and very little is absorbed, it has virtually no systemic effects on the body and side effects are minor if present at all. This is particularly important to someoneof ]amie's age." "Over the last 15 years at St. Joseph's,we have developed a better inhalation therapy system called an Aero Chamber inhaler. This device consists of an aerosol-holding chamber with a valve at one end and a soft rubber opening at the other, into which any medication puffer can be inserted," Dr. Newhouse sys. The pediatric aerochamber used on Jamie has a soft silicone mask which is applied gently, but firmly, to his face so that when he breathesthe medication that hasbeensprayed into the holding chamber it is automatically delivered to his air passages. Dr. Newhouse notes that as well as making it possible to easily give aerosol medication to infants and small children, this system has another mapr advantage."It removesthe large aerosol particles that are not useful for treatment, which would otherwise accumulate in ]amie's throat and be absorbedto cause possible side effects." judy is pleased with this approach to her son's therapy not only becauseit is extremely effective but also because - unlike a nebuhzer - the aerosol puffer and aerochamberis easily carried, can be used anywhere and needs no power supply. A COURAGEOUS ADAPTATION TO KIDNEY FAILURE chronicled the eventsthat led to their need for came bloated. Becauseof congestion in her hemodialysisthreetimesa week at St.]oseph's. lungs she needed a tracheotomy to help her lune,62, describedthe time nine yearsago breathe- an experiencewhich convincedJune An exampleof the work done by the neph- when she required surgery on her Fallopian to give up cigarettes. rology and kidneyunit is found in thestoryof tubes. The operation took place on a Friday. Junerememberedlittle of the time that she Robert and ]une Bomes. During swgery/ the doctor noticed that the teeteredbetween life and death. "In rcu I was It is hardly surprising that a couple would opening of her kidneys had started to close. dialyzed for the first time but I didn't know it. have a great deal in common after 38 years of Robert remembershow the doctor explained I was quite dopey but I remember coming to marriage. But Robert and June Bomes are that the tubes in his wife's kidneys were "like consciousnessonceand I saw Robert standing unusual in that they both experiencedcom- rusty old pipes." there," ]une said. plete kidney failure within the last 10 years. By the next day both kidneys failed to Above the drone and beep of monitoring On October7,7989, they sat acrossfrom function at all and ]une's condition becameso equipment around herbed, one nurse made a each other in matching easy chairs in their critical she was moved to the intensive care lasting impression on june. "I will never forcomfortable two-bedroom apartment and unit. Due to the retention of water Tunebe' get the nurse who sang hymos as she worked in the unit. I would be half-awake and could hear her singing. I did not know her name but tTl it was so peaceful to listen to her," she said. I he FirestoneRegional Chest and Allergy are from the Hamilton-Wentworth region, When June's condition stabilized she Unit is an example of the benefits a medical the total population from which patients are moved from rcu to a hospital room. Initially, school has had on the hospital. ]amie Weber drawn is closer to one million. The region is the staff wheeled her bed to the dialysis unit. is one of the 16p00 patients who are keated bordered by Oakville Niagara Falls, Simcoe, 'llater I graduated to a wheelchair. For the each year at the unit, which is located on Drnnville and communities to the east of first week or so/ it didn't click. I looked at my Charlton Avenue West. London and south of Georgian Bay. arm and saw the machine.I couldn't feel anyThe unit, which opened on December 5, The ambulatory care provided by the thing even though the blood was going in and 1979,evolved as the result of an initiative by unit provides investigation and treatment out of my bodyi' June recalled. "Then I realthe respirology service at St. ]oseph's and for a range of respiratory ailments related to ized that I would depend on this machine for McMasterUniversity Medical School.At that seriotrs pulmonary diseasessuch asbronchithe rest of my life. It took almost a year to time the land,buildingand equipment rep tis, emphysema,asthma,lung cancerand tureally accept it. I learned to watch everything resented a milliondollar investment. The berculosis. Treatment is available for adI eat and drink." Firestone Foundation contributed almost verse drug, food or bee venom reactions as June refused to view dialysis as a life sen$500,0ffi to get the unit started. Its successor, well as occupational health problems. tence or a causefor self-pity. "One day, while the Firan Foundation, continues to provide The Firestone Chest and Allergy Unit is I waited for my ride home from the hospital,I assistance. The provincial government committed to research as well as the educasaw some patients who seemedto be in worse funded construction costs and continues to tion of medical shrdents and residents.There conditiory" she said. "They were people who provide major funding through the hospitafs is also a major commitment to patient inwere confined to a hospital bed. They could global budget. struction in self-care by physicians, techninot go home, but I could. From then on, I acAlthoughthe majority of patients served cians and nwses. cepted that I had to live with dialysis." + The couple lived in Stoney Creek when june was discharged from the hospital. Each 78 week she spent almost $60 on cab fare to get back and forth for treatment.Eventually, they moved to an apartrnent just two blocks from St.Joseph's. Roberf s introduction to kidney failure was more gradual but he, too, ended up on a dialysis machinethree times a week. Nine years ago one of his kidneys had beendamaged in a driving accident and it was removed. A person can survive with surprisingly little kidney function - as little as one third of one kidney - so Robert consideredhimself forhrnate. Three years later he suffered a severesetback when a tumor in his bladder pennanently affected the function of his remaining healthy kidney. For the last four years his survival has also depended on the artificial kidney. He requires regular surgery to remove the recurring tumors. Their lives revolved around dialysis. ]une went on Monday, Wednesday and Friday morningsfrom 8 a.m.to 1 p.m.Robertgoeson the samedays from 3 p.- to7:30 p.m. Robert 'nVhen says the last haU hour is the longest. you're finished you feel weak and tired. It takesa couple of hours to feel better." On the dining room table is a box crammed with eleven medications he must take every day. Each prescription is designed to assist the body in some function which is normally controlled by what amounts to the kidney's 'chemistry lab'. Robert must be vigilant with every bite of food and sip of fluids. Salted foods, for example, are taboo because they help the body to retain too much water. He has to be careful with fmit - oranges, bananas, tomatoes - because they contain potassium. At first it was a difficult diet to follow, but Robert has found that some of the things he thought he would miss don't bother him any more. "For example, if I wanted to, I could drink three bottles of beer a week " Robert explains. "The funny thing is,I used to really enjoy a bottle of beer and now I cannot even tolerate the smell of it. One thing I miss, however, is Chinese food, but I am not allowed to eat it becauseof its high potassium content." Becausethey spent so much time at St. June felt quite close to Joseph's,Robert and 'Dialysis patients depend the nursing staff. on the nurses and they really go out of their way to help. We get caught up in their lives and when they get engaged,married or have children, we're happy too." Each week 85 patients receive dialysis at St. Joseph's.Robert has a graft in the upper left arm which allows accessto the bloodstream for hook-up to the artificial kidney. The kidney is a cylindrical shapethat contains a bundle of hollow fibres. Blood Passes through these fibres and the rinsing fluid passesaround them, Purifylng the blood be' fore it is returned to the bodY. Dr. E. KinseyM. Smith,headof St.Joseph's nephrology department, says Mr. and Mrs. Bomes' made "a courageous adaptation" to their lifestyle change and dependenceon he modialysis. Juneand Robert felt they were luckier than other people becausethey could leave the city for at leasttwo days at a time. "In the suruner we scheduledour treatment for the sametime and then we took off to Iake Erie. I can't hunt now but I get out in the boat and go fishing," Robert says. 79 CO.OPERATION BETWEENHOSPITAL AND MEDICAL SCHOOL The prediction made by a newspaper reporter in February, \963, - that the link between St. Joseph'sand McMaster University for radio-isotope research would be a vital factor in the creation of a medical school was on the brink of becoming a reality. After the death of Dr. Charles ]aimet in the auhrmn of 1962,Dr. Kenneth Ingham was appointed as head of St. Joseph'sradioisotope department in 1963.Drring that period Dr. H. G. Thode, president of McMaster University, announcedDr. Ingharnlsappointment as medical consultant to the McMaster nuclear reactor project. At the time, Dr. Thode said that Dr. Ingham's dual appointment followed the precedentof co-operationestablishedbetween the two institutions in 1958(when the university and the hospital set up a radio-isotope laboratory at St. ]oseph's).Dr. Ingham recalls when the medical school was on the horizon. "h1963Iwas the onemedicalmanatMclvlaster. I remember talking to Dr. Thode,when he was considering candidates for Dean in the Faculty of Medicine. He was keen on having Dr. John R. Evans becausehe felt he would have the energy to be able to do all the necessary, hectic things." Evenhrally, Dr. Thode did selectDr. Evans as dean for the new school. As chairman of the liaison committee be' tween university and hospital, Dr. Ingham was sensitiveto the requirementsof making a medical school fit into the medical community at the time. "It was inevitable that we would get a medical school.We neededit and Healthy kidneys carry out their sophisticatedfunction 24 hours a day. Most people are reminded of this only when the bladder exerts pressure to be emptiedseveraltimes eachday. The industrious kidneys are taken for granted as they purify the body's blood and-remove its wastes, but they do much more. A normally functioning pair of kidneys constantly do the following: 1. Regulatethe amount of water the body should keep or excrete from sources such as ddnks and food; 2. Maintain a balance of the body's potassium,sod,iumand calcium, for example,which are derived from the food we eat 3. Regulateblood pressure; 4. Help produce red blood cells; 5. Help the body use the calcium it takes iry 6. Provide the best environmmt for cells to grow and live by hetping with the acid/base balanceofthe body; and 7.Play a role in thdproduction of various horrnones. Dr. Smith explains that initially the artificial kidney was developed at the end of the SacondWorld War to treat acute kidney failure which had resulted from battle trauma. The original artificial kidney was cnrde and cumbersomecompared to the equipment used today: The original artificial kidney was made of wood, was about the size of a small desk and looked like the paddle wheel of a river boat, with tubing wound around the the wheel. The dialysis fluid was mixed by hand and stirred with a paddle. There has been great progressin the careof thesepatimts. Today the artificial kidney buys time for those suffering from chronic kidney failure. iod we transplantup to 4Opatientsper year. Regional dialysis unit At a medical advisory meeting on April6, 1965,Dr. William Goldberg ask& the Medical Advisory Committee for support for the general idea of instituting a chionic dialysis unit in St. Joseph'sHospital. He said he had For patients with acute failwe, the artifi- made informal contacts with people on the cial kidney h"lped deanse the blood until departmental level of other hospitits and felt kidney fu nction could be restored. Subsequent that it would be reasonablefor the unit to be refinements made it an appropriate method 1lt rp at St. ]oseph'sto serve the whole city. of keatment for patients who suffered the de. The question of space and the expenseof a bilitating effects of chronic kidney failure. Dr. director for the unit were his main concerns. Smith continued: Three months later, on July 5, Dr. Goldberg announced that in January, 7967,Dr. In the mid-to-late 1950schronic Arthur Shimizu would head the renal unit. kidney failure was a complex The delay was due to the fact that Dr. Shimiuu diseasethat affected the whole was in Cleveland, gaining experiencein renal body. The only way out was transplants. death or transplantation. Until Matthew Dymond, Ontario health minis1967, those with chronic kidter at the time, officially opened the $100,000 ney failure had to die an unfive-H unit in September,'1967.lnemphacomfortable death. sizing the unit's role in regional provision of With their kidneys not workhealth serviceshe said, "The complexities of ing patients would be swolhealth careare zuch that there can be no room len, weak, pale, nauseatedand for any competition. It may have beenall right breathless. They would bleed 75 or 30 years ago, although sometimes this into the bowel and skin. The competition was motivated by a desireor mad build-up of toxins in the body rush for status." would cause great distress, Dr. Goldberg added, 'The fact that a confusion and convulsioru. medical schoolwas developing at McMas- 80 ter,Univ it){:-rrlade,,it possible,to,,getthe to set up :the:unit",:You $l.lppqrt:n Coul${t. ha+e,a unit:,of,!!tib.:caiibre,other:,.,.,to*ay,thAregionat.Aialtsis s€roesa population baseof 1.9million who live in the area bordered by Tobermory to the north, London to the-wesLSt. Catharines to the south and Toronto to the east. A total of 200 patients receive treatment through one of several programs develop at$1.Ias's;herno{ialysis,peritonealdialysis, self-caredialysis and home hemodialysis. , Dr.,Smith saysthat although the unit resulted from the efforts gf science,the hospital and the university, it is, above all, a tribute to team work "It is the people who matter - those who sweep the floors and maintain the rnachines, the dietitians all the staff who work for the patients' welfare," he said. Over the years/ the unit has received generous assistance from area organizations. The Sertoma CIub, for example, donated a van n 1976to service artificial kidneys in patients' homes. In 1978, through the fundraising efforts of the Hamilton East Lions Club, Camp Dorset was officially opened in the Muskoka re$on.It is set up so that dialysis patients may receive treatment while they enioy a $ummer vacation with their families. As well, contributions from the Kidney Foundation make the purchase of equipment ' and furyiqhings possible. , SisterMary lane Ryai oi c oisit to Gilda Cino, a dialysis fatiint for elmost 2Q;yeari. Mri. Cino iliid on Septentbet25,7986,of renal failure causedby c91tp licatiotrs fr oim a ktdtuy transplait ,gpet ttioti.,,,Gil44'.,is,|cidty,,,., remembetetles ai aciioe anil etthuisiai tic i o luate et futnryaeroushospiial fuabaising eoetrts. Thc oVefingof Cenp D or*t, e summcr sccstiort eanp fot di ely sis p atients end thek femilies. 8l everyonefelt that Hamilton was the right size," he says. "But we wanted to avoid the 'town and gown' problem. The school had to serve the medical needs of the community as well as the overall needsof training new people." Doctors were asked to contribute to the new school's curriculum. They gave a great deal of thought to what was wrong with their own medical training and how that could be correctedfor future students.lnterestingly, in an new age of specialization,one area which theyagreed was lacking was family medicine. "At that time there were few, if any, faculty membersteachingfamily medicinein any North American schools.We had great input from family doctors on that aspect," D.. Lgham recalls: There were two currents of interest.One was to make family medicine obsolete by having interns and pediatriciansdo all of the primary care. The other said that a strong need existed for family practitionersto serve as the first-line, personal approach to the families and coordinate the other specialties. There was enough strength in this second idea that it be' came accepted.Almost all faculties of medicine now have family medicine and firll faculty members with the necessary authority. Everyone recognized that in a traditional medical school there was no course of study in general practice.The usual referenceto it was a rather derogatory 'look what he orshe hasmissed.'Not enough role models existed. So there was not much doubt that generalpracticewould fall by the wayside and disappear if there were not an academic situation where studentscould see someone whom they admired and would like to emulate doing that kind of work. St. Joseph'shad an impact on the medical school's curriculum by establishing clinical '"We had a teaching units in family practice. full department of family practice long before the other hospitals in town," said Dr. lngham. On December?3,1969, after listening to Dr. Evans outline all the pros and cons concerning an affiliation with McMaster Universitp Sister Mary Grace took her pen in hand. Although she was apprehensiveabout guiding St. Josephs in its venture to become a teaching hospital, her doubts were easedby the knowledge that staff and patients would benefit. Before signing the agreement, she recallsslnng to God: "You signit." "The decision to become involved with McMaster and the development of clinical teaching units meant that St. Joseph'sdeveloped its own specialties,"said Dr. Galloway. 'nVhen I came,in 1965,researchat the hospital was minimal. Today it is a very significant aspectof St. ]oseph's." St.Joseph'sbecamethe first hospital in the city to establish a formal accord with the medicalschool.The schooland hospital shared a common goal - to teachgraduateand un- dergraduate students in medicine and nursing. As medical director, Dr. Galloway ensured that the university and hospital responsibilities were welldefined in theagreement."Ifelt the agreementshould recognizethe hospital's responsibility for quality patient care while the university was responsible for tmching and.research,"he said. "I did the legwork on the affiliation agreementwith Mclv{aster,but it was the result of tremendous co-operation between the Sisters, the board of trustees, administration, physicians,the medical advisory committee and many staff members." On May 1.6,1972,Dr. Galloway addressed the first class to graduate from McMaster University Medical School and received an honorary Doctor of I^awsdegree. A later affiliation with Mohawk College permitted students to gain practical and clinical experiencein physiotherapy, nursing, occupational therapy, radiology and medical technology. Dr. Galloway added that the medical school acted as a catalyst for another important event at St. josepfi's - the transition to a board of trusteesfrom the lay advisory board which had beenin placesince1952."The board of trustee with representativesfrom the Sisters and the community brought expertiseto develop and manage the hospital," he said. Under the Public Hospitals Act, it had always been necessaryto have a governing board. St. Joseph'sgoverning body was comprisd of a council of five Sistersand a group of lay persons who served as their advisors. This original advisory group/ however, did not have delegated authority. At this point in the history of St. Joseph's, Superior General Mother Alacoque and the Congregation's Council changed from the advisory board concept to the board of trustees.They delegatedto the board the responsibility for operating St. ]oseph's according to establishedbylaws within the philosophy of the Sistersof St. Joseph. Mother Alacoque imposed only one condition in the selectionof the board of trustees: she asked that Dr. Jim Osbaldeston be the chairman of the firstboard formed on June19, 1968.'I do not know why this was and I do not take any credit for it. Ifs unwual for a doctor who is a member of the staff to serveas chairmaru becauseit could be seen as a conflict of interest," Dr. Osbaldestonrecalled. William Scullp general chairman of the hospital's first public fundraising campaign rn'1,961, and Dr. Osbaldestonbegan the selection of board members.'nVe drew up a list of names," Dr. Osbadestonsaid. 'The require. ments were that eachmember had to be board calibre,a person who knew how to operateon a board, and each one had to bring a particular skill and areaof knowledge to the hospital - law, finance or public relations, for example. Then Bill and I went to visit eachprospective member." The term'trustees'was adopted,the board was incorporated and given its mandate. It still setsthe rules, regulations and bylaws by which the hospital operatesand is answerable to the Sisters.As owners, the Sisters determine policy and a Mission statement that governs how the hospital should be run. Sister Ann Marshall explained that the board's function has altered little since 1968: The Corporation of the Sisters of St. ]oseph owns and operates the hospital, but we have given certain authority to the board. For example, the running and upgrading of the hospital is the board's responsibility. The board invests money, appoints heads of departments and the executive director. They cannot, however, incur debt without our authority, and they cannot buy or sell land. Appointments to the board must be ratified by the corporation, but other than that they really do have the major functioning of the hospital. After some intense growing pains, St. ]oseph's emerged with the confidence to direct the future of many of the community's health-careissues.It is now a tradition at the hospital to identify and solve new problems. Part of its mission statement reads: "For the future, St.Joseph'sHospital plans to continue to provide exemplary health care with an emphasis on spiritual and emotional needs, as well as physical care,to all in need." Two departments which have been established within the past 20 ymrs - Pastoral Service and Palliative Care - demonstrate the hospital's successin caring for the nonmedical needsof patients and their families. To use the analogy of building construction - the Sisters'philosophy is both cornerstoneand foundation of St. Joseph's;the serv- 83 ices provided by the hospital - from diagnostic and medical to surgical- are thebuilding materials; Pastoral Serviceand Palliative Care form a special adhesive which bonds them altogether. These departments were developed through the compassion and efforts of the Sistersworking in co-operationwith dedicated staff members from many disciplines. They add substance to the comments "there is something different about St. ]oe's" and "I'll only come to St. Joe's," made by so many patients when they're trying to explain why they feel so seflrre in the Sisters'hospital. Chapter Ten LEADINGTHEWAY Wid.-r"r,ging discussions in the mid-1950s, when planning of health care servicesfor the entire region began in earnest, revealed that services were lacking in Stoney Creek and Hamilton's growing east end. Although it took 25 yearsto develop by the end of 1990St. joseph's Hospital will open an ambulatory care centre to meet the needs of that population. Once again the Sistersof St. Josephwill demonstrate their commitment to the wellbeing of the community. Area health representatives met at St. ]oseph's on February 1,, 1965 to discuss regional needs.At a secondmeeting on February In Apil7985 Sistetloqn O'Sullioan celcbretesprooincial gooernmentapprooal of St.loseph's Community Health Centreaith Frank Millel utho utes PrcgressioeConsentqtioePremier of Ontario at the time. 84 '1,5,1965,1v{r. T.A. Rice,president of the Hamilton Health Associatioru said: Regional planning should indicate where further hospital de' velopment should occur. Expansion cannot be determined only in terms of hospital units now in existence. Should there be an additional unit? Where is the growth coming? Current expansion at the General,Henderson,St.]oseph's and Chedoke hospitals and the proposeduniversity hospital will be sufficient to service certain areasof the community for some time, although the patterns of areas so served may alter with the pending changes in main traffic routes. Currently, overcrowding at the Joseph Brant hospital indicates need for expansion there. However, regional planning might reveal that since 20 per cent of thejoseph Brant'spatients comefrom the StoneyCreekarea, and sinceHamilton is expanding farther into Stoney Creek, an entirely new hospital unit might be required in that area. The discussionon regional planning of the area's health care facilities eventually led to the formation of theHamilton-Wentworth District Health Council n 1976.The following year, the council pwsued Mr. Rice's concern voiced in 1965 that the health needs of the region's population to the eastand thoseliving in Stoney Creek be adequately met. Subsequent developmentsrevealthat while Mr. Rice was a man of vision, the Sistersof St. Joseph !\rerewomen of action. A thumbnail sketch of events shows how St. JosepKs Community Health Centre be' came a reality and provides yet another example of how the Sisters'mission continuesto be carried out. 1977 - A steering committee of the health council studied the accessibilityof health services by residentsliving eastof Parkdale Ave' nue and identified services needed for this area. At this time the population of the area totalled 72,5n. January, 1979- The health council commissioned management consultants Peat, Marwick and Partnersto do a costbudget analysis of the site redevelopment for the Hamilton General hospital. In August of the sameyear the council recommendedthat the Hamilton General be rebuilt on the present site and a communitv health servicesfacilitv be built in the east end of Hamilton-Wentworth. The ambulatorycare unit resulted from the efforts of countless concerned citizens. Dr. Robert Kemp 77, is one of many who de' serve mention. Dr. Kemp recognized the need for a hospital in the eastend asearly as 1960."IrVhenthe ]oseph Brant hospital was built in Burlington in 1960,I found it was quicker to get there from the east end (than to drive downtown to a Hamilton hospital). It had beds and parking available," he said. "Also, it made more sense to send my patients there as opposed to a hospital in the city becausethe consultants I used had moved to joseph Brant." rate proposal on the scoPe,nature and costsof a conununity health service facility to serve the east end as soon as possible so that its development would take place concurrently with the rebuilding of the Hamilton General. The community health service facility was to be managedby one of the Hamilton hospitals; the servicesoffered to be integrated with the existing network of servicesand programs in the district. March, 1980- An east end community task force was setup in conjunction with the health council. Members met regularly for the next advi December,1979 Mr. Dennis Timbrell, then year and had input from a professional to forums open and citizers committee, sory minister of health for Ontario, acceptedthe Hamilton Both the services. needed identifv recommendation of the health council to re' an interest build the Hamilton Generalon its presentsite. Generaland St.]oseph's expressed He requestedthat the council develop a sepa- in managing the facilitY. 85 A group of concernedcitizens formed the East Hamilton-Stoney Creek Health Association in the 1970s."INe lobbied every government and made noise to get our own hospital," Dr. Kemp said. "Since then there have been so many changesin medicine and health care that the need for hospital bedshasbeenreduced.The ambulatory care facility, and the home care provided in conjunction with it, is a shining example of how to care for people on an outpatient basis." The $5,S0 proceeds from a testimonial dinner held in honour of Dr. Kemp in 1986 were donated to support the construction of the centre. t October, 1,982- The health council recommended to the ministry of health that St. Joseph'soperatethe proposedsatellitefacility. January, 1983- Following approval by the ministry of health, St. joseph's commissioned Peat, Marwick and Partners to do a master program/master plan. The services needed were reaffirmed and meetingswere held with hospital staff, physicians at the hospital and those located in the east end, multiple health and social servicesagencies,as well as representativesfrom the faculty of health sciencesat McMaster University to ensure that planned serviceswere well integrated. September, 1984 - The Corporation of the Sistersof St.]osephpurchased26acresof land at King Streetand Nash Road.Ten acreswere designated for the ambulatory care centre. May, 1989- Construction started on a building designed by Trevor Garwood-jones and erectedby Pigott Construction. December,1990- projectedcompletion date. St. ]oseph's Community Health Centre at King Street East and Nash Road is located exactly 10kilometresfrom the Sisters'original 2Fbed hospital on john Street.The centre has a view of the escarpmentto the south and St. David's Schoolto the north. On the west side is St.NicholasSerbianfthodox Church with its domed roof supporting a cross. The centreis a two-level building with an exterior cladding of prefinished aluminum on the second level and split-face concrete block finish on the first level. br time, the oak and maple treesplanted around it will further soften the exterior and bring the building into greater harmony with its environment. The judicious placementof evergreenshasalready begun to fonn a privacy barrier for the residential neighbourhood to the west. C-anopiesprovide shelter to three entrance points - the main door, the entrance to the geriatric day centreand the accessfor patients who arrive in need of urgent medical attention. Designing the centre took almost 18 months. Architect Trevor Garwood-]one said the greatestchallengewas to createa technologically sophisticatedenvironment that would be warm and welcoming at the sametime. He is pleasedwith the results: St.]oseph'sCommunity Health Centre is at the forefront of health care design. It offers a new type of care designed for clients rather than patients. Because ambulatory care is meant to keep patients out of institutions, it alters the philosophy and approach to de' sign. This centre portrays the fact that it is technically advanced and on the leading edge. Hospital design in the pasthasbeen cold and institutional. This had to changebecausethe weak and the sick have a right to a beautiful environment. Inside, several light wells with skylights allow natural light to penetrateboth levels.A bright, cheerful environment is enhancedby the use of colours such as terracottaand warm shadesof blue and green. To create a welcoming environment, he used warm pastel colours for the interior. A skylit atrium brightens the main entrance.For the comfort of the many elderly citizens who willuse thebuilding, corridors havebeenkept as short as possible arrd are bathed in natural light at regularintervals. Carpeting rather than sheet vinyl flooring has been installed wherever suitable to createa homey atmosphere. The centre will provide a unique mix of services.The west side of the lower level is a centrefor thosein needof urgent care- babie with croup and patients who arrive with fractures, or cuts. Although minor surgery will be available at this centre,it will not be called an emergencydepartment becauseit will not have 86 theback-up of hospitaladmission. Thegoal is to stabilize patients who require transfer to another hospital for admission. Other service on the centre's first floor include radiologp laboratories, occupational therapy and physiotherapy. A geriatric day hospital on the east side will assessand treat seniors who do not reqtrire hospitalization for their medical problems. The second floor will deal with diabetic education,speechpathologp audiology, psychologp social work" pastoral serviceand St. Joseph'sEast Region Mental Health Services. The centre, built at a cost of $18.9million, will employ approximately 150 staff. It will cost almost $6 million per year to operate.By the end of the 1990s,the population it serves will have gtown to 109,000. {I @g t') !+ {o o a o F' CS it \:i s* o F \ \ D Q d la |! c t. E (o to sq G FI s E t T .-o |! G F E !o E (a I Fl t t. it 6 $ IS t s. |! t s ! o s T o F s : N 2 s $ s(t G s F: $ G' (,l it oe x $ t il e\ c' il s s s & ti E G l< : : tE o' F (a' aa \ (a G \o 60 6;l I AD (o H q s N s ;r D (! ;r * * $ Il) I 0 s a 11 r+ rt o d F t $ f\ + R li s (< o s s b- o| +J c( (a tr s a H s As executive director of St, Joseph'ssince June 1989,Allan Greve is interested in preserving thosefeaturesof St.Joseph'swhich distinguish it from other hosprtals: We often hear the rerrrarkmade by patients, former patients and members of their families, that 'different' there is something about St, Joseph'sHospital. It is the presence of the Sisters, the adherence to the Christian values of the Roman Catholic church, the commitment to care of the total patient and the family, the high morale of our staff members, and their dedication to the patients and to their jobs that make that difference.These values and the pride associated with being a part of St. ]oseph's Hospital do edst and are encouraged. As it has always done, St. Joseph'spreparesfor the future by embracingthe most current medical and technologicalchanges and passing on the benefits to its patients. One of those benefits is ambulatory care. "There is an increasedfocus on diagnosis and treahnent on an out-patient basis," Mr. Greve says. "At present, 40 percent of all surgical proceduresare done through day surgery But with advances in technology - from fibre-optics and new instruments to laser and comput€rc: as well as suF port for patients at horne,this will move to the 60 percent range." In the nextdecade,hepredicts St.Joseph's wilt participate in further regionalization of clinical programs: With additional information and specialization, the cost, medical skill and specialized nursing and support staff re' quired to support a quality program willrequire a centralized and regional approach to tertiary programs. We will need enhancedmanagerial skills and a medical/hospital staff working in harmony in order to meet the demand to operatea caring, labour intensive and highly technological health care system' t 89 Allan Greoe ssswned thc position of Facctrtioe Dhector st St.loseph's in fune,1989, Chapter Eleven THE NURSESREMEMBER rrt I he hospital's history would noJbe complete without a look at the nursing staff who helped the Sistersof St.Josephcarry on the work they started in the cholera sheds in the 1850s.St Joseph'sSchool of Nursing attracted generations of young women, and evenhrally some men, who felt called to a demanding and re. warding career in the care of the sick. They were disciplined, hard-working and self-sacrificing individuals who brought honour to their schooland to St.]oseph'sHospital. When the hospital opened in 1890,the labour-saving devicesthat are taken for granted today had not yet beeninvented. After a day of caring for their patients, the Sistersdid all the manual labour required to maintain safe and pleasant conditions. Except for the volume of laundry, wash day at the hospital was not much different from any other household in the city. To keep the white bed linen and towels at their brightest, they were boiled in homemade soap in a large copper pot on the stove.The rest of the wash would be done in a tub and scrubbed clean over a board. Before tackling the housework, a Sister pinned up her skirt and sleeves,fastenedher veil back and donned an apron to protect her starched, white guimpe. The Sister responsible for the hospital paperwork recorded charts, accountsand businesstransactionsin meticulous long-hand writing. In the kitchen, all the food wasmanually preparedand served. SisterVirginia Hanlon tailght ifl the school of nursing from 7957to 7964. 90 The Sistersdid their own bakinp preserving and canning to keep the larder well stocked. By 1911,the hospital had grown to twice its original 25-bed capacity. The Sisters recognized a pressing need for additional trained nursing staff if St.Joseph'swere to continue to provide for the community's healthcareneeds. The opening of a training schoolfor lay nurses in 1911was made iust in time for the hospital's next growth spurt. Five years later, the addition of a new surgical wing increased accommodation by 100more beds. The hospital was staffed in 1911by nurses who had beentrained by SisterMartina Long aged 51, and SisterLeo Cass,52. Both women had received their nursing education in Kalamazoo, Michigan. On September8 of that year, the first students were poised to begin their training. At the age of 29,SisterGerard Moran was the first Sister to enroll. In 1950she was still on the hospital staff at age 68.To house the students and provide classroom space/ the Sisters bought Adam Brown's residenceat the corner of St.joseph's Drive and Mountwood Avenue, then known as Alma Avenue. Each girl wore a crisp, blue and white cotton uniform made at home according to strict specifications.On laundry day the garments were starchedto perfection.Apart from some minor changes,the same uniform was worn until 1965 by generations of students who remember them as uncomfortable to wrestle into, with long sleeveseven in summer, stiff collars and cuffs. How thesewomen would have rejoiced at today's dripdry fabrics! A shrdent knew shehad clearedthe initial hurdles in her training when shewas awarded the hospital was the student's first priority; formal educationcamesecond.Shemust have had impressive stamina, since classestook place in the evening when doctors and nurses were free for lectures.Four doctors are credited with laying the foundation of the nursing school ThomasHugh BaUe,IngersolOlmsted, james Edgar and Herbert Sullivan, Sr. Some students admit they viewed their teachersas gods to be feared and yet admired - such as Dr. Ingersol Olmsted - or loved, such as gentle, portly Dr. Thomas Balfe. On January 22,191.5,with their three'year course of shrdy completed, the first classwas ready to graduate. They were Ada Egan, Dunnville; Ella Kelly, Mount Forest;Margaret Hamilton, Guelph; Angela Halloran, Butte, Montana; Helen Carroll, St. Catharines;Clara Grant, Toronto; Anne Maloney, Lillian Furrey and jean Morin all of Hamilton. The graduation ceremonytookplace in thelecture hall of the nurses' residence at 8 p.m. Prominent members of the city's clerg!,lay and medical professions,joined family and friends as the nurses were presentedwith huge bouquets of pink roses and heard addresses by Mayor Mother Martinc Long, 7860- 19.8, Supeintcnilent of Chester Walters and Dr. Balfe. When asked tlw hospital in 7934. about their plans for a private celebrationfolthe school cap, which was withheld until she lowing the event,Ada Eganand Anne Maloney was considered worthy of it. Many were so replied,'nVe'll return to duty and to our Pakeen they earned the privilege in a mere six tients." Dr. W.P. Downes, the hospital's first inweeks. Their day started at 6 a.m. with uniform inspection, Mass and breakfast before tern in 1916, was a popular teacher in the going on 12-hourduty at 7 a.m.Their arduous school of nursing. Known affectionately as days were relieved by a one'and-a-halfor two- nVilie P. Downes', he loved education and hour break. Eachweek all students had a haU- anything related to it. He had been a teacher before entering medicine and when he joined day off which began at noon. Mostof a nurse'strainingwasof thehands- the staff at St.Joseph'she took over much of the on variety - she learnedby doing. Service to nurses' instruction. Having taught schoolfor a number of years,he may havebeenolder than today's intern perhaps,but his enthusiamwas ideal for a young and growing hospital. Ln7920,plans were begun by the Ontario government, as with other provincial legislatures, to enact a registration law which required all nursing students to write departmentalexamson thecompletionof their course. This was the signal for extensive improve. ments in all schools of nursing seekingprovincial approval. To meetthe new requirements,Dr. Downes gavean intensive review courseto the classof '1,926, which was the first to write the n.r.r. exams. All the students passed. For years it was a proud boast that not one of St. Joseph's nurseshad everfailed the examination.At the end of every review, Dr. Downes gave the sameadvice: "The night beforethe exam,have fun.It's time to relax.By now the die is cast." St.|oseph's Schoolof Nursing made a special effort to prepare its students for advanced Dr. Thomas Hugh Ba$e with studetts itr 7977. 92 work and, in choosing candidates for the course, preference was given to those with superior qualifications. The Sistersand staff insisted on a very high standard in those who took the course.Applicants were not formally admitted until they had demonstrated their fitnessduring the four months' term of probation. By 1921,the hospital had grown to accommodate more patients,which createdthe need for more nurses.An increasein student enrolment promised to burden the alreadycrowded residence.As a result, the Sistersfaceda fresh bout of opposition reminiscent of their hospital's opening. This time it concernedthe need for a new nurses' residence. In the fall of l92l,thefoundation for a new residence and classroom was started on the site of the original building. When construction got underway nurses were displaced in scattered living arrangements - 35 in one house on John Street,27 in another and 23 in the hospital itself. Both St. Joseph'sand the Hamilton General had approached the city at the sametime forassistancein financing new homesfor their nurses.St.Joseph'sneeded$50,000. Onceagain, religion played a part in the debate.Because the loyalty of the taxpaying citizens was divided between the two institutions, envy, suspicion and resentment pitted one side againstthe other. TheHamiltonSpectatorrelievedsomeof the tension when it assessedthe factsand pointed out that of the 2,7'1.0patients treated at St. Joseph'srn1920,just over 1,800patients were non-Catholic. Furthermore, indigent patients of all religions were routinely admitted and treated for free. hr a plea for co-operation,the paper reasoned: It is a public institution,largely availed of by Protestants,who areby no meansconfined to the wealthiest classesin the community. The needfor the home is urgent and many Protestant nurses are in training at the institution. Let the question be consideredwith an open mind, free from bitternessand, above all, free from religious prejudice. A great public work is being done by both hospitals for the general good of the community. The merits of the appeal should be considered on that basis alone. It should not be forgotten that Roman Catholics have to contribute to the upkeep of the city hospital and will have to pay their share of the proposed nurses' home in connectionwith it. Eventually, the amount requested was promised by the city, to be paid in two instalments.In true bureaucraticform, however,the wrangle carried over to the spring of the following year, when a new city council took office and threatenedto renegeon the second instalment pledged by its predecessor. The contentious issue was evenhrally resolved in favour of St. joseph's receiving the full amount. W.H. Yates Construction Company of Hamilton completed the new Undermount residencein one year and on Tuesdap November 28,'1922,it was officially opened. llndermount, School of Nwsing openeil on Nooembet 28' 7922. Citizens who supported the Hamilton General were also satisfied when that hospital opened its new nurses' residencethe same year. Forhrnately,the funding debateat city hall causedno bitternessbetween the two institutions. ln fact, four years later, when a scarlet fever epidemic closed St. ]oseph's to visitors and struck a number of its nurses,the board of governors at the General decided that St. Joseph'snurseswouldbe treated at no charge. Undermount had as much style as sub' stance.Studentswere attractedto the schoolas much for the new residenceas the curriculum. Outside it had terracedlawns and landscaped 93 plots of shrubs and flowers and a tennis court for the students.The Sistersenteredthrough a large door facing north, while studentsused a door facing east. Toronto architects Stevens and Lee planned the interior. TheSpectatorgavethis detailed accountof the "rich yet tasteful" surroundings: just inside the door is a small officeand telephonebooth, and to the left is the living-room. Like therest of the rooms in the building, the living-room is furnished with polished oak grandfather clock. A mohair chesterfield suite, a walnut piano, walnut tables and several other choice pieces of furniture complete the room. The library, which opened from the living room by sliding doors,tradwalnut bookshelves set in the walls. On either side of the walnut and white marble fireplace were French windows that led out to the sunkengardens.Above the fireplace was a scarletpanel, with the rest of the room a cream shade,a carry-over of the living room colour scheme. Opening off the main corridor on the first floor were a kitchenette,cloak room and sewing room. At the end of the hall was a bright, airy lecture hall with 12 windows, a blackboard, charts and equipment for chemistry instruction. Shrdents sat in oak chairs with arms wide enough for note-taking. Ninety-three nurses lived on the the second and third floors. Most had single roors measuring 108square feet, with identical furA close-upoiew of Undernount, St.loseph's School of Nursing uhich stood at the cornerof St.f o*ph's Drioe and Mountuood Aoenue. floors. The walls are tinted a light cream.Three French windows lead out on to a balconv along the front of the roo-. At one end of the room/ in a little arched alcove, is a large open coal fireplace of red tile and walnut. The wall panel in the alcove is of scarlet, lending a warrn glow to the place. Hangings of striped pqple velour, trimmed withdull gold are over the windows and in the panels on the wall are two long mirrors in bronze frames. Three large crystal chandeliers furnish the lighting for the room. The floors are covered with Wilton rugs, and in one corner of the room is a walnut 94 The stately lioing room of the Unilermount nurses' residence. nishings,thedetails of which arerecalledtoday by some of the earlier grads. Walls were gray with buff trim, polished oak floors were scattered with Wilton rugs, curtains and bedspreadswere either rose or blue. At the end of a long day, nurses slept on new Marshall mattressesplacedonSimmons metalbeds of a dull walnut color. RoseSchmalz(later RoseDiemert), a nurse who graduated in 1925, was particularly impatient for the new residence to open. As a student she lived in an old house on Charlton Avenue,oneof the temporary homesfor nurses while Undermount was under construction. "It was my first time away from home and I was homesick It took a long time to adjust. Eight of us slept on old hospital beds in one large room.ln 19?3we moved into the new residence." For many it may havebeenthe most luxury and privacy they had ever experienced.Each room was equipped with solid, black walnut furniture - a fivedrawer chiffonnier with a plate glasstop, a night table,a tapestry-upholstered arm chair, writing desk and a small chair. A spacious closet was outfitted with shelvesand hooks. The porcelain wash basin had hot and cold running water. Thedoorwas madeof BritishColumbia fir finished in mahogany. On the door was the room number and student's name printed in Old English lettering. A quick uniform check could be made in the ft.rll-length mirror. Fully equipped bathrooms on each floor had terrazzo tiles and marble partitions. To get to the hospital from their residence, nurseswalked through a 175-footunderground tunnel. In fact, after a snowfall, its outline can be determined as the warm air in the funnel melts the snow directly above it. Its location roughly correspondsto the present overhead walkway built in 1980that crossesSt.joseph's Drive. As the hospital and its schoolachievedthe high standards set by the government, civic pride swelled. Ceremonies and accolades became more lavish with each year's graduation. On |anuary 25,1922 hundreds of citizensgatheredin the Hamilton CollegiateInstitute to honour the 15 young graduates,each carrying a bouquet of red roses.Adding to the excitement of the occasionwas the presentation of diplomas by Sir JohnHendrie, who had been knighted during his term of office (1914-791,9)as Lieutenant-Governor of Ontario. Thc Spectatorreported: The large hall was gaily decorated for the occasion with garlands and sheafsof flowers and the artistically arranged stage made a charming background for the pretty girls in their crisp white uniforms and becoming caps. In his address to the graduates Sir John Hendriesaid: "No vocationsowellfitsa woman for the highest development of her sex as nursing, for it brings out the best characteristics and servesto eliminate the less desirable ones." Dr. Downes reminded the nurses that it was imperative to study their patients if they were to be successfulin their profession,adding that asgraduatesof St.Joseph'sthey would 95 Right:Rose Schmalz (maffied nameDiemert) on a breakfrom the operating rcom uith het friend Eilith Digby (married nameMaj eske)in 7923, either be an honour or a scarupon their school. At the June, 1926, gtaduation the Hon. Lincoln Goldie, provincial secretary of Ontario, lamentedthe number of Canadiannurses who were being claimed by the u.s.eachyear. Again in May of 7929,D.. La..l' Playfair of St. ]oseph's expressedconcernthat nursing ranks in Canadawere being depleted by emigration to the u.s.,where the large cities offered great inducementsin the way of handsomesalaries. "Matrimony too, took its toll," he added. In 1915,the year the first nursing classgraduated, the nurses formed an alumnae that re' mains active to this dav with a current membership that is 600strong.Under the convenorship of graduatesAda Egan and ]ean Moriru members assembledto formulate a constitution and bylaws. Another graduate,Etla Kelly, became the first president. Once organized, they immediately undertook fund-raising activities for the benefit of the hospital and their alma mater. Through private donations of up to $20 and a dance held at the Royal Connaught Hotel, they raised enough to help furnish the living room of the new Undermount residence n7922. When linen was neededthe following year, again they responded with individual donations of $5 to $10. In1925, they presenteda chalice to a mission in WesternCanadaand bought linens for the Sistersto embroider for the mission's altar. Such generosity was remarkable considering the rate of pay for 12-hourduty at the time was $3.50. Over the years the alumnae continued to further the interests of students and the hospital with prizes to graduating nurses for general proficiency, cash donations on the opening of new wings and gifts of money to the school library. Dt. In ry Playfair taught physiology in thc tursing school. In a speechgiven at heralma mater on October 8,1969,SisterVirginia Hanlon traced the evolution of nursing educationin Canada.In part, this is what she had to say about how those developments affected St. joseph's training school: Eachnew definition of "nurse" reflects advances in the medical and social sciences.The result has been nursing functions that are increasingly ex- 96 acting and diversified. But, there was a time when service to the hospital took precedence over the educational requirements. This was the case in the early 1900sin Canada. From the outset the aims of the hospitals were in conflict with the aims of the schoolsof nursing. The nature of the development of the schools - and the learning experiences offered - indicatedthat their purpose was to provide charitable services ratherthan education.Students wereadmitted to the schooland immediately assigned to the wards asworkers; teachingwas incidental. Vast strides were made in the scienceand practice of medicine dating from the latter part of the 19th century. With this renaissanceof medicine, the whole conceptionof the careof thesickchanged.No longer was a hospitalseenasaplacewhere one goesto die, but rather as a placeto go to regain health and return to the community. With wide hospitalization camean increasingdemand for nursing seryice, and as hospitals evolved to meet the needs of the community so the character of nursing service developed and changed, often ac- cording to the individual needs of the hospital. Prior to and during the 1920s, students who enrolled in our school were assigned to duty on the wards the day after registration. The school cap was merited three months from the beginning date of the course. After the nurse was 'capped' she could be assignedto night duty. Besidesthe prime responsibility of patient care,the student was responsible for the housekeepi.g io each clinical areato which shewas assigned. The shrdent replacedthe maid on the maid's halfday off. Her duties then consistedof brioging the food to the wards from the main kitchen, serving the food on the trays and carrying it to the patient, following which the trays were washed and set up for the following day. A senior nurse (a third-year student) did all the incidental teaching on the wards. During theday therewasa SisterSupervisor on eachward, but a head nurse or graduate staff nurse was an unknown quantity. Ninety per cent of the nurses who graduated did private duty nursing. Dr.iog the night the hospital was staffed solely by students, with one Sister Supervisor. Thefirct classof graduates on fanuary 22,7975. 9't By the 1930sand'40s,classes were glowing in size and as a result, the number of nursing lechrres increased and classes were no longer included in offduty time. But conflict often arose when a student wanted to leave the ward for classbe. causeservicetook precedence. In the mid40s, however, more lectureswere given by doctors, emphasisincreasedon curriculum planning and a Sister instructor was appointed to assist the director in teaching. This Sister teachertaught 90 per cent of the content in the areaof nursing and an increasing number of doctorslectured, too. The first clinical instructor at St. Joseph's,Miss Sylvia Hallman, was appointed in 1944.Her function was to assist the studentsin the clinical situation. As in all areasof education, St. joseph's School of Nursing was affected by the Second World War. Classeswere increasing rapidly in size, more residenceaccommodationhad to be obtained and additional graduate staff nurses were employed, thereby removing some of the service responsibilities from the students. Clinical instructors,clinics on the wards and casestudieswere Marygrooe utas built in 7869at the cotner of f ames Stteet South anil St.loseph's Dioe. The hospital purchased Marygrooe on Septembet75, 7917,for u* as a nurses' regidetce.Ia 79(i0it utas demolishedanhenconstruction of the neutsurgical building began. introduced. Ea.ly in 1950,the block system of teaching was initiated. Studentswere on the wards from 7 a.m. to 10 a.m. From 10 a.m. to 4 p.m. was set asidefor classroominstruction. The final block of time from 4 p.m. to 7 p.^. foundthemback on the wards. Resistanceon the part of nursing serviceperson- 98 nel to this new philosophy of teachinggradually gaveway to acceptance. We advanied to a system whereby the pre-clinicalperiod (not probationary) was extended, with lessand lessserviceand more and more emphasis on education. Second-year shrdents were off the nursing units for longer periods, with no commitment to service,and all the formal classes were completd in the first two years. The third year was one essentially of service, but as more qualified teachersbecameavailable for clinical teaching, a gr eat deal of teaching took place in the hospital setting. With increasd concentration on education rather than service, new facilities were provided for students- an expandedlibrary, emphasis on research, more audio/visual equipment. "As the service and educational responsibilities grew, there was a separation betweenserviceand education,with a director for each area." Oakbank rnttaes'rcsidetce, built fot lohn Stinsonin the miil-7850s,utas locateil at 307f amesSfueetSouth, Eiluail, the Pince of Wales,stayed et Oakbaak in 7860zohenhe attendedthe opedng cercmoniesof the city's watenoorks system. 99 Irene Murray was 18 when she entered training, only five years after the school opened. Much later, at age 92, she recalled the experiencethat shaped her desire to be a nurse: My mother, a widow with six children, was operated on by dear old Dr. Balfe. I remember how good all the Sisterswere to her. I was so grateful that I decided that I'd go into training so that I could look after someoneelse'smother. ln"l.9'1.6,I moved into the nurses' residence - the old Adam Brown home - on the corner of Alma Avenue and Mountain Drive. It was a lovely big housewhere I shareda room with three other girls. My family lived on John Street,across from the Church of The Ascension. The laundry ironed our uniforms and I remember those big, full aprons and great stiff bibs were sostarchedyou could hear them rustling down the corridors. Our instructors were the doctors and we stood up when they entered the room. It was different then, it was the Old School.At age 17 or 1,8 we looked on them asgods.We were scared stiff of Dr. Olmsted and Mother St. Basil. She was very particular. The Sisters knew more about us than we did about ourselves.They were like our mothers. I was brassy and spontaneous a couple of times, though. One time Dr. H.j. Sullivan, Sr. said 'what the hell!' and I asked him if he belonged to the Holy Name society. Another time, one of the Sistersasked me to take on the job of floorsupervisor. She said I had a couple of weeks to think it over. When the time was up sheaskedagain and I told her I wouldn't do it becauseI didn't want to be tied down. I don't how I had the nerve to do that. As a student I didn't like maternity or the operatingroom but I really enjoyed surgical nursing. For pain we had morphine and pneumonia was treated with a mwtard plaster. We didn't have the antibiotics that are available todav. Our classof sevengraduatd in the chapelthat was at the front door of the john Street entrance to the 1890buitding. Sincethe patientsupstairshad to goto sleep, we had no dance or party. It was all over by 11 p.m. After that, I was always a private duty nurse becauseI didn't like the routine of staff nursing. One job took me to Scotland,Ontario.A farmermet Irene Munay on her graduation ilay February 23,7919. 100 me at the train station in his horseand buggy and we drove about seven miles out into the country to his home where I caredfor his wife, who had the 'flu. That was 24hourdutvand I had to sleep on a scratchyold horsehair couch. My patients were always interesting.I nursed many clergy members.If I had a private case at St. Joe's, I'd walk from my home on Gladstone Avenue, over to Delaware Avenue and StinsonStreetand on up the hill to the hospital. After changing in the locker room I'd go up to the cafeteria and have breakfast,all beforereporting to duty at 7a.m.Pay was $3for l2-hour dutv. In September,1924, studentFlossGoetz(later Floss Smith) took a seat at her first lecture in the nurses'residence.Apart from desks,chairs and a blackboard,the classroomcontainedthe few learning materials of the day: a skeleton and hospital beds containing training models of an adult female and a baby. In the months aheadFlosswould learn the art and scienceof nursing: how to give alcohol rubs and needles and - by practising on a fellow student - how to take a patient's blood pressure,temperature and pulse. SisterAssumption Kehoe,44,director and supervisor of nurses,stood at the front as she welcomed the eager class of 20 girls in their Stuilcnt ntrses in the Unilermowrt classtoom. probationers' uniforms - a white aPron with a three'inch waistband buttoned at the back worn over a long-sleeved blue dress which was accentedby a starched white collar and cuffs, high-cut, laced black shoes and black stockings. On that first day Sister Assumption conveyed little of the military-style discipline for which she was feared and revered by her students. She was also a dedicated woman who had her students' successin mind at all times' Her opening words at Floss' first lecture were: '1(our first duty is the careand comfort of your patient." To Floss,a girl with dark, wavy hair and a shrdious demeanour, those words becamethe motto of a career she had planned at an early age:"I enjoyedvisiting sick relativesor friends and wanted to do something for them. My mother was always behind me with a jar of homemadesoup or a bag of cookies." St. Joseph'sin Hamilton appealed to her becauseit offered modern, new facilities, a new nurses' residence and affiliation with a FlossGoetz (matieilname Smith) grailuateil in1927. 101 Thefifth classto graduate - Irene Muray (standing far left). t02 fuberculosis sanatorium and psychiatric hospital: We lived in Undermount where we had our own rooms, tastefully furnished with a single bed and bedside table. There was a desk with a gooseneck lamp and chair,blue bedspread and curtains,a chestof drawers and a clothes closet as well as our own sink and mirror. Toilets and bath tubs were located on each floor. just insidethe front doorwas themail room and to the right of the entrancehall was a large,nicely furnished living room with a piano. To the left was Sister Assumption's office and two bedrooms. The classroomwas located at the end of this hall. At 6 a.m. a merciless bell, which was rungby hand,could be heard ringing up and down the halls. There was uniform inspection and attendance takenat 6:30a.m.,breakfastand on duty by 7 a.m. During our 12-hourshift we had two hours off, but thesewere often given up forlectures from Monday to Friday. Eachweek we had half a day off, giving us enough time to take in a show at the old Pantages Theatre on King Street, but if therewas a lechrreduring that time, we had to attend it. The Pantages,which later becamethe PalaceTheatre,headlined vaudeville actsand entertainers such as George Burns and Gracie Allen, the Marx Brothers, Bing Crosby, Bob Hope, Red Skelton and Edgar Bergenwith Charlie McCarthy. We had three hours off on Sunday. On night duty there were no spare nurses, so if a nursebecameill, one of the day nurses would remain on for 24hour duty. When the day shift ended at 7 p.m., students often ran down to a favourite Chinese restaurant on John Street where the bill for breadedveal cutletsand vegetablesorchicken with rice,and a pieceof bananacreampie, was 25 cents - ideal for the first-year student whose income was $5 per month. While it wasn't exactlygourmet fare it was an escapefrom the hospital kitchen. "Cafeteria meals were nourishing but plain, starchy and monotonous. I gained 25 pounds in three months and took immediate steps to reduce when I could hardly fit into my uniform." Curfew was set for 10 p.m., at which time all students had to be in their bedrooms.One night a month there was a late leave of 11:30 p.m. It was compulsory for nursesto sign in at the hospital office and return to residencevia the underground hrnnel, a dreaded walk at that hour becausethey passedthe morgue en route! Taboos governing behaviour were abundant, but in the spirit of the young and resourceful they were overcome. 'tsoyfriends were hard to come by and fraternizing with nurses from other yearswasn't allowed. But it was fun to have the occasionalnight out with an intern or single doctor - strictly agairut the rules, but worth the chance!" Sandwichedbetweenthe demandsof duty and discipline was the nurses' formal education. Medicine was taughtby Dr. W.P.Downes, anatomy by Dr. H.]. Sullivan, Sr.,and physiology by Dr. L.L. Playfair. 'l remember Dr. J.K. McGregor, who was then the recognized authority on thyroid surgery, his brother Dr. Douglas McGregor and Dr. IngersolOlmsted." After the four-month probation in the first year, the "probie" got her bib and cap. It was a proud day in her third year when the black band was added to the nurses'cap, signifying that she was a senior. Along with the black band came the privilege of wearing white Oxfords and white stockings in the summer months. She also moved to bed-side nursing, which was taught in Iecturesand demonstrations bv the Sisters.Floss recalled: Ourinstructor for nursing procedure was Sister Mary Assumption, for medication Sister Loretto Gainor and for obstetrical nursing and careof the newborn, Sister MercedesGallagher, who was supervisor of CasaMaria. We learnedhow to change surgical dressings and carefor diabetics sufferin g from gangreneor the amputation of a foot or leg. Sterile procedures in the operating room were taught and we had to know the contents of a sterile tray re- quired for the doctor to remove drainage tubes or stitches. end first and coaxed down by sips of water.) "My prettiest red rosescamewith a card signed: Protesting that it was an impossible feat, the 'From Madge, with love."' patient cried 'all right, nurse/ you swallow it Resporuibilities increasedwith each year and then I'11try'. With a Sisterat her side, Floss in training. A third-year nurse learned how to gavea reluctant but successfuldemonstration. JeanetteEaglesham,(later JeanetteSimpson)a catheterizea patient under strict asepis,to do The patient, who struggled for over an hour, nurse who graduated in 1925, has a vivid a sponge count after surgical proceduresand eventually managed to get the string started memory of the day she applied to the school: to chart patient care at the end of a 12-hour and her throat was cleared. shift. She also served for three months in the One of Floss' happiest experienceswas a On a lovely summer day n1922, operating room, where Sister Gerard Moran voluntary arm-to-arm blood transfusion given my Uncle |ohn and my grandwas supervisor and instructor of on technique: to an ll-year-old girl named Madge, who was parents brought me to St. brought in bleeding profusely through the ]oseph's to be interviewed by Patients with a simple appennose: Sister St. Basil McClarty in her dix or hernia and maternity office just inside the huge front patients were kept in bed for 10 She was transfused a number door of the building on |ohn days.Abdomina I incision-swere Street. The following Septemof times during the first three supported by a scultetusbinder. days but she kept on bleeding. ber I was brought over again to Patientswith maior surgery I was on night duty and it was start my training. such as malignancies, bowel evidentthat Madge was indire SisterAssumption wasSuperobstruction,amputations,perineed of blood, but there were intendent of nurses then and tonitis, or mastoid - remained no more donors available.I told she ruled us like the American in bed much longer. Nursing at the doctor that I would gladly army, with which she had the time was made all the more give blood. served in the first World War in challengingby the fact that there France,attached to the AmeriFollowing the transfusion, her were no antibiotics, no insulin, bleeding stopped. Madge was can Nursing Service.Our varino Salk vaccine and no serun taken back to her room and ous classeswere attended on for diphtheria,typhoid, whoophandled with care.When I went schedule. Dr. W.P. Downes ing cough, measlesor fubercuinstructed in maternity and Dr. on duty the next night, there losis. was still no bleeding and she Woodhall in surgery. Dr. Olmwas in great spirits. She went sted booked classesfor 7 a.m. At times,training alsosummonedstudents home on the tenth day. so that he would not be held up beyond the call of duty. In the absence of later in the day. Our gradusophisticatedequipment or a battery of theraFlosswas named valedictorian in her 1927 ation took place in the auditopeutic drugs, some innovative nursing tech- graduating class and many years later she rium of Undermount on a warm niques were often employed. worked at the Red Cross, organizing mobile day in 1925.Everyone looked On one occasion,Flosswas challengedby donor clinics, when new procedures such as lovely in the new white unia patient suffering from a stricture of the eso- heart surgery createda demand for blood . forms. phagus.The prescribedtreatment was to have Successand accoladesaside,Flosssaid her I still have a pichrre of Sister thewomanswallowa string of beads,(knotted fondest memory of graduation day was that Loretto teaching me the differ104 ent instruments to use in the lower on for tonsillectomy. When we finished our training we earnd $5 for 12-hourduty. When I retired in 1965 it was $33 for eight-hour duty. \AIhen there was a shortageof private duty nurses,I joined the nurses' registry. By her own admission, Dorothy Williams entered training, in january 1935,just to escape the chronic unemployment of the 1930s. When her training was over,however, shewas committed to a careerin nursing. Graduation exercisestook placeat 3 p.m. on June8, 1938. Dorothy had a job within the month. Years later, in 1985, she wrote to Sister Mary Grace, who had retired as hospital administrator, and in the letter explained her initial reluctanceto being a nurse: feanette Eaglesham(mefiied tcme Simpson)rcceioesinstruction on insfuumentsh the operatit g room ftom Sistet Loretto Gainot. 105 At one time, in my teens,I said I would never, never/ never be a nurse. But workwas scarcein the 1930s,so I went in training. I am sure had we had a yearbook,I would have beenvoted the one most likely not to succeed.I was a mouseand not too bright. Sister Monica Smythe knew that! I also said I would never, never work in a psvchiatric hospital. But on Irny i, 1938,I started to work at the Ontario Hospital and gave myself two weeks' trial. I staved vearsand Dorothy Williams (beck rou, eight in from the left) utith her clqssmateson graduatiott ilay lune 8,7938, 106 loved it! Now it is onemonth to our next reunion and I am sorrv I will not be ableto attend. Iast year's reunion was absolutely thrilling and I was so proud of my school. I want somone to know I did a-or by *y Alma Mater. Leona]ohnson (LeonaHudecki) applied to St. joseph's nursing school and paid the $35 tuition feewithout telling her family. Sheentered on September4,1938,the day she turned 18. 'tIntil then I had beenundecided about what to do with my life. At one point, I seriously considered entering the St. Joseph'sCongregation," she recalled. For all the rigors of training, the student pay remained the sameas a decadeearlier. ln her first year, a student received$6per month, with a onedollar increaseeachyear: The wageswere more a kind of allowance.If you broke a glass syringe, it had to be reported and it was deducted from your pay. It was the samewith anything that was damaged. Uniforms were difficult to get into becauseof the long skirts and celluloid belts, cuffs and collars.You could loseyour cap and bib or your black band for misdemeanours, so you were constantly trying to do your best. There was a strong senseof seniority among the students. Graduation ilay May 22,7!N,1l"eft to ight: Itona lohnson (married netneHudecki), Dt, Iolm Tilden and FrancesO'Brbn We even had to open doors for the seniors.If you happenedto be visiting with a senior when Sister Monica made one of her routine inspections in residence,you had plenty of warning becauseher beadsrattled as shecamealong the corridor. To avoid being penalized you would hide in the closet or under a bed. Lipstick, nailpolish and rouge were not permitted. Hair had to be worn up off the collar. After four months' probation and if we passedthe exams,we went right on to 12-how duty. 107 Two nurses would be responsible on a ward of 30 to 35 patients. On nights, at around 2 a.m. we would go into a little room off the main lobby of the old building, take off our shoes and capsand nap on one of the couchesfor about an hour. There was no emergency department. Badly injured patients were admitted right to 100Surgical.Every floor had a Sistersupervisor.On third-fl oor Surgical, SisterVincent Bergin ran a tight ship. Shewas a real little pepper pot! Shewas short and chubby,but ascuteascould be. At night she would come down for her 's{ - spiritusfrumenti - and put it in her milk and sugar. She said it helped her sleep. (Doctors ordered a half-ounceof spiritus fmmenti, a distilled product with a sedative property, to be administered to patients who had trouble sleeping.) SisterVincent also had great sympathy for the post-operative patient who had lost interest in eating. To revive a patient's appetite she would cook up a filet mignon to perfection, surround it with a ring of peas and deliver it personally to the patient. Without fail, the patient responded,asmuch to the geshrreof extra kindness as to the food. Nursesalsoused to prepare the occasional meal to tempt a patient's appetite: We had one nurse who wed to like to practise her shot by throwing the egg shells across the room and into the garbage. One morning Sister Monica enteredthe kitchen at the same time this nurse had taken aim and she accidently hit Sister in the eye with the egg shell! I marvel now at some of our responsibilities. To prepare a hypodermic needle we would light the bunsen burner, put water in a spoon to dissolve the tablet of molphine and pull the solution up into the syringe. We did this after four months' probation. For high fevers we gavealcoholspongebaths,liquids and aspirin. Gigantic pads were taped with three-inch adhesivefor surgical dressings. Sutures were big and black. When we changed a patient's dressing and sponged the wound we used to say, nVe're going to take this bandage off in one short shriek.' The Second World War de. pleted the hospital staff of interns which left nursing supervisors responsible for many decisionsaffecting patient care. ln those days, all we had for cardiac arrest was oxygen. We did a lot of on-the-jobtraining. If an rv or blood transfusion was needed we did it. I don't even remember being shown how, but I lnow I did it. I re. member preparing a man for surgery and I didn't know where to start the rv - he had no anns. Somany times we threatened to quit, but of course we never would. We had hard work, sorrows and resentments.I'm still close with my classmates. We get together at reunions. Nothing in my life comparesto those three years we trained together. When she graduated on May 22, 1941, Leona recalled: "Our brothers and boyfriends were gone.The usual music played for graduation was Pomp and Circamstance.Our class had been anticipating this beautiful march in. InsteadThere'll Alwrys beanEnglandwasplayed becauseby that time we were consciousofthe horror of the war." As cloistered as the religious life might have beenin the 7940s,it did not meana Sister had no interest in affairs of the heart. Leona's favourite story is about the night one of the Sistersplayed match-maker for her: It happenedon New Year'sEve, 1942.The students were having a dance.SisterMary Grace found me moping io *y room and asked why I was not going to the party. 108 DAtr{Cts -1" 4r,r,, t r/ - ' /44/ L/r.,,1.,,,,1i,,y L {,," .1 5t. ;|',,y1' ",.//,,,,;t,,1 ,t {.r,1 i..,".,,.11t St,,,l;rl,t/J,,"," "4,t,1. ,11,.,,,1.,1, .,11"y zat/,, tglt et i.3o y.ut. g;ll J,,,1**', C,,/,,,"r,,, 5",- rl,r;*1 sr.zsi",,,/, Ticket to the ilance ht honow ol the 7W graduaiing class. Then sheled me to thedoor of the party and said 'Look at the big tall Captain in here. Now put on your dress and go!' Well, I had this white silk moire dresswith a big bow and beautiful, billowing skirt. It had cost me almost a year/swages! So I put it on and in I went. Student and graduate nurses didn't fraternize at that time so therewas quite an uproar when I arrived. Anyway, then the students asked the band to call a dance named the Paul Jones,but the band didn't know how. I did becausemy father was an oldtime fiddler a.rd he taught me to call square dances.I volunteeredto call the danceand after that I was welcome to stay. The handsome Captain objected to the energeticstepsand shook his fist at her every time he reeled by. Later in the evening he was introduced to the pretty, vivacious nurse. His name was Stan Hudecki. He was bright, inquisitive and had already spent a year's fellowship in pathology at the Banting Institute in Toronto. He had even greater plans for the future and St.Joseph'sHospital itself cameto benefit from many of them. Dr. Hudecki and nurse johnson married in 1945.They had nine children and 42 happy yearstogetheruntil he died in his sleep on June26,1988. As a result of the war, nurses were needed around the country and overseas.St. Joseph's respons€ was to admit three classes,rather than the usual two, in 1944. Mary Fitzgerald (later Mary Marrin) entered that year.Accommodation was stretched to the limit by the 53 students enrolled, Mary recalls: The July classwas made up of older women with work experience. At the end of my first year I had to move home becauseof a lack of accommodation. But we still had to be at the hospital for Rosaryat 6:45p.m. if we were onnights and report for duty between 6:30and 6:45 a.m. with the rest of the classif we were on days. SoI made the 20-minute walk back and forth from my homeon HunterStreet West. Mary spent her entire nursing careerat St. joseph's, the hospital in which she was born. All schoolshave their traditions. One tradition atSt.Joseph'swas that the Septemberclassdid not like the intrusion of students who arrived in February. A cool reception, strict teachers and the demands of training were disheartening to newcomers. kene Maclnnes (married name DeCoste)was a spunky girl with a ready laugh thenightshearrivedin 1953from Prince Edward Island: Iwas metbya seniorwhotook my suitcaseand said that if I weresmart,Id turn around and go right back home. I had been apprehensive,to put it mildly, and her commentsdid nothing for my confidence. The nextda/, in a small classroom in the basement of Undermount, we struggled into our blue and white uniforms while Sister Virginia read us a kind of 'riot act.' She went through all thethingswe should and shouldn't do. SisterBonaventureFagan,the Director, told us what the pen.altieswould be if we disobeyed any of the rules. We were told what time to be in, what we were to do and to have respect for everyone. I remember my first week on the first floor of the Medical building, where the headnurseran a pretty tight ship. We bathed and fed patients, got them out of bed and made the beds, all within the first week on the wards. 109 Ircne Maclnnes (married name DeCoste)grailuated in 79ffi It gives me chills now to think of the responsibility we had. We did the bestwe could, using little measures,to make the patient comfortable.We worked from 7 a.m. to 10 a.m., when we broke for classuntil2 p.m. Then it was back on the wards until5 p.m., although it was seldomthat we got off at that time. It was the sameroutine the next day. Education was secondary. We had to learn on the job and there was really nothing wrong with that. I learned a lot about humility in that first year. If we were sitting in the lounge, we had to stand and acknowledge any senior who entered and get her coffee if she wanted it. If you sat down and another one entered, you did the samething again. I often thought that therehad to be better days aheador I wouldr/t be a nurse for very long! Irene did stay to graduate in 1956and was happily working as head nurse on 2 Private when Sister Virginia cropped up again in her life. I was called to an important meeting in the linen cupboard -because officespacewasnonexistent.Sisterwas planning to start an innovative health programfor the staff and askedif I was interested in it. I told her definitely not, becauseI really liked working with the patients. Nothing more was said until two days later when she told me she was going to advertise the position and that I should apply. Again I said no, but then shedecidednot to advertiseand the job was mine. It was different then. You did as you were told. At first it was primarily a student health service.Bit bybit we expandedand started things such as immunization programs.By about 1968 we zeroed in on all employees, doing pre-employment and routine physicals.It grew from there.Hospitals wereone of the last groups to get in on what industry had been doing for years.At the start,I reported to Sister Virginia and later, came directly under the personnel department. Today it is called the PersonnelHealth Unit. Sis- ter Virginia really knew what she was talking about. In 1959,the employee health service also hired a medical director of the service, Dr. Robert McHarg, who continuesto work in that capacity today. "I applied to St. Joseph'sSchool of Nursing becauseit really was considered to be one of the best nursing schools in the area," said Margaret O'Donnell (married name Obermeyer ), who graduatedin \972andrxalls the two yearsshespentintraining as"A greatpart of my life. I also had worked as a candystriper at St. Joe'sand have an aunt who nursed, so I leaned toward the profession." Her room, 407- on the fourth floor of the Fontbonne residence- facedthe hospital. By the time she enteredtraining, the student lifestyle contrasted dramatically to the rigid "old days." Boyfriends could be entertained in Fontbonne'scommunallounge.Greenculottes were the uniform when students went out to do community work at St.Pete/s Hospital or the RygielHome forthe mentallyhandicapped. When the legal age for drinking was lowered to 18 there was even the occasionalpub night: Residence life was great. We would study late at night and run down for chocolate bars, soft drinks and potato chips from the tuck shop, which was located where the spinal centre is now in Fontbonneon the first floor. Sometimeswe made our 110 own meals of mushrooms and hotdogs, which we bought at the rca on JamesStreet. By the late 1960s,a nurse's education reflected and responded to the many new specialties that had developed in medicine. Initially, a student spent more time in the classroom. But with so much more to learn, the emphasis shifted to acquiring theory before undertaking practicaltraining. A sophisticated curriculum was divided into neurological, cardiovascular, respiratory, gastro-intestinal and genito-urinary training as well as sociologp pyschology, language and communications. Margaret remembers: A typical school day meant we were up at 8 a.m.- unlessyou were in clinical - then it was 6:45a.m.Classeswere held from 9 a.m. to noon and from 1 p.m. to 3 or 4 p.m. It was a big treatto run backoverto residenceafter classto watchGeneralHospital on television. Practical experience was usually two mornings a week. It started with a pre-conference about our assignments and ended with a post-conferenceabout what occurred and a discussion of problems. In the afternoon we were back in the classroom. Sister Mary David Wiggins was the onlySister instruitor I had and she was a sweetheart. Virginia Frereis anotherteacher still have the friends I made in nursing school.We learnedhow to live in a group and share everyone'sexperiences- both good and bad. Fontbonnenurses'residenceopenedin 7962just 77 years beforethe school of nursing closed-Today it is usedlot doctors' anil administration offi ces. I remember. When she came down the hall, we hid. She would drill us on our patients, check the beds and Lord help you if you weren't prepared! My graduation day, June 16, was warrn and sunny - but my aunt wore her mink stole anyway. The exercisestook place at Mohawk College with BishopRyanand Mayor Copps as guest speakers.We entered the hall to the music of Pomp and Circumstancewearing white, long-sleeveduniforms. I made my first formal dressfor our graduation dance held in the Fontbonne auditorium. I llt In preceding generations, when a young woman announcd her engagement it was understoodthat, oncemarried, shewould leave nursing. By the time Margaret graduated marriage presentd no such obstacle.She got married after graduation and was employd by St. Joseph'sto work as a staff nurse in the intensive care unit, where she enjoyed the patient care and the drama and excitement. From there she transferred to the operating room and, after upgrading her education, she applied for her presentposition as head nurse in the emergency department. Emergency work, shesays,is "exciting, becauseyou never know what is going to comethrough the door." Margaret regrets the shift from hospitalaffiliated schools to community college nursing programs. "I don't think nurses graduating from a corrununity college can have the sameloyalty or senseof belonging to a hospital. I have such a strong feeling for St.Joe'sand they've beenvery good to me here." Pat Yip ChucKs (married name Wright) intimate bond with St. Joseph'sgoesback to her high schooldays,when shewas a candystriper. As a young volunteer she worked in the renal transplant unit. The exposure to hospital life and observing the way nurses handled their patientsappealedto her.Working at St.]oseph's was also a family affair: her father worked asa budget officerfor the hospital and her mother was a supply core technician in the supply department. After graduating from St. Mary's High Schoolin Hamilton, Pat enrolled in St.]oseph's nursing school in1971and moved into room 5l0atFontbonne residence.Althougha nurse's training was no less rigorous, her curriculum and method of learning differed significantly from that of the first class of young women who entered the school. The courseof study was condensedto two yearsinsteadof three.Self-directedlearning in groups of no more than eight students replaced the former lecture.styleteachingto 100 students at a time. Pat recalls: My first year was an experimental year with self-teaching modulesabout the nervousand gastric systems, reproduction and maternity, pediatrics and orthopedics.We had an instructor but the shrdents did their own research.It was difficult at first because in high school everything was given to you. Our day started at 9 a.m. On Monday morning we had a general assembly session.The instructor would outline the course of study for that week and explainwhat they expected us to learn from the module. Then we would work in groups of five or six students, sharing with the otherswhat we leamed from our research. In small assemblysessionswe would discuss problems in a tutorial style. The philosoPhy behind selfdirected learning was to gain confidence and maturity. It taught us how to function as a team and how to tackle problems. Ratherthan watch a classroomdemonstration of basic nursing skills such as how to changedressings,give injections, remove sutures or take blood pressure, students were expected to schedule their own time and view tapes on these procedures in the library. By following personalized timetable, students were permitted to progress at their own rate. When they felt prepared, they booked a Practical test which had to be passedbefore they could practise the procedure on the wards. From Monday to Fridap the learning re' sourcecentrein Fontbonnewas open between 8 a.m. and 10 p.m. to accommodatethe individual study habits of students.With the shift in emphasisfrom teachingto learning, the staff hoped that nurses would retain the skills to teachthemselvesand continue their education after graduation. Sister Ann Marshall, who directed the rhool of nursing in 197'1.,said, 'nVe found that most of the students,by working at their own speed,learnedfasterthan ever before." Blue and white were still the colours of the student nurse's uniform, but it had significantly altered in style from when the school opened in 1911.Gone were the traditional starchedbib and apron,long sleevesand deep cuffs. The'70s shrdent wore a blue and white tt2 pin-striped, shirtwaist-style cotton dresswhich buttoned down the front. It had short sleeve and two side slashpockets.A small concession to the old uniform could be seenin the modified whitebib inset at the neck. As dictated by fashion at the time, most studentshemmed the skirt to slightly above the knee. White stockings and white duty shoeswere still part of the dresscode.Hair still had to be worn up, off the collar. Facial make'up was acceptable,but nail polish or pwellery were not. Nails had to be well-kept. Room, board, tuition, meals and books were provided by the school.Student life had relaxed considerably compared to the early days. "Curfew was 11 p.m. We had to sign in and out when we left residence. But sometimes,if we were late,the security guard would let us in and not say anything. On Sundays,we were allowed to have visitors in our roors, as long as the door was left open. On occasion, some girls successfuIlysmuggled visitors into residence via the tunnel that led from the hospital," Pat remembers. 'nVehad a refrigeratoroneachfloorwhere we could keep food. But the food was often stolen, so I used to keep mine in my room, on the windowsill. SisterJoanC/Sullivan was the director of nursing in my secondyear and she lived on the fourth floor of Fontbonne. The girls got along well with her. My best friend in nursing school was Sister BarbaraGraf, a fellow student. We still keep in touch." At the end of her first year, the student nurse added a blue band to her cap. Before graduation the black band replaced the blue band. a S R E3 R"* F* bl! $$3 Rq: t$ *bs l ts$ T HFX 5: a:. F $'ii s P.o O $$t sEs 5 (A q Fo (')S !+o T$ F.* F€ +: oa riil *D$ i$$ $3l. EES !t D ss. < At 2 p.m. on July 20,1973,Pat's classof 130 students (including three male graduates) assembledin the theatre at Mohawk College on Fennel Avenue East.They were participating in anhistoric eventin the life of St.Joseph's - it was the 60th and final classto graduate from the school of nursing. In Septemberof that year, nwsing education transferred to community colleges.Although St. Joseph's continued to operate as a campus for the Mohawk College nursing program, its era as an independent school had ended. The school's closure deeply saddenedthe students, Pat said: iA" oo/ tfr" Qta/uottng 5o8""[ 5t. t"*pf''" Q.ol"otion ot't".ooor, tuty ninzteen fru,rLt/ on/ Jzt/ag txzzcite* tX" LwzntbtL, sr"nty-tLta at two o'ohoL Colt.g. J4oBo*E t3s Jrr"r[[ Pat's ties to St. ]oseph's,however, continued to be strengthenedas she worked on the pediatric ward for 11 years after graduation. Shemet her husband,Dave,through oneof her little patients. All three of her children were born at the hospital. Today she works as a labour and delivery nurse - a job she loves. "There is no place in the world I would rather work. I meeta variety of peopleof all ages.It's a happy place!" The final graduation ceremonywas all the more poignant for the list of dignitaries who attended. It was an historic occasionfor both the hospital and the city. The city's seventh bishop, PaulF. Reding, (who was delivered on Feb. 14, '1924,bythe hospital's first intern, Dr. W.P. Downes) brought greetings from the rgzs "t' of JVuzdng Ctooo inoltz you to Le pzztenL at oo"/a[y Jfr" We belongedto thehospitaland its traditions. We identified with St. Joe'sand had a sentimental feeling for the hospital that today's nursing graduates can't have. of bu.otore B"o./ o4orru. ifr'ot " (W.st JJamilton also born at St.Joseph's- 6n \fgw Year's Day in 1952.The speaker, Sean O'Sullivan,* had made Canadian history when he became Canada's youngest member of parliament. Although the sun shone for an hour and temperatures hoverd around 80F, the day was mostly cloudy with light showers. Nature, too, seemd to mourn the closeof an era. Also suited to the times and the mood was the selectionof music that day. The musical background to the presentationof classpins, Simon and Garfunkel's Bridge oaer Troubled Water, touchedthe graduateswith its lyrics and words of despair mixed with optimism. The 60th graduatingclassstarted theirday with the celebrationof Massfollowed by breakfast in the cafeteria.The day concluded with a dance at the Royal Connaught Hotel. But the joy of the occasion and the pride of having their achievementrecognizedby "their school and hospital" was tinged with the sad knowledge that such camaraderieand spirit would be denied to future generationsof nurses. e$J.mirtion [y tt"fi.t onty lmtitation to the grailuation exerciseswhich took place on luly 20,1973. diocese to the graduates.Board of control memberRobertM. Morrow, who later became mayor of Hamilton, extendedcongratulations from the city. SisterJoanO'Sullivan was the last director of the school of nursing to present the graduation pins. Finally, Dr. James Osbaldeston introducedthespeaker,a yonng man who was 115 tAfter a fiveyearpoliticalcareerSeanPahickC/Sullivan entered the seminary and was ordained to the priesthood in 1981.Father OSullivan diedin theearlymorninghours of March 9, 1989after a five-year battle with leukemia. Sister Joan's nephew was always affectionatelyreferred to as "Father Sean". ggv-t* - *PROCESSIONAL - PRIZE Land of HoPe ond Glory -Edzt'ord Elgar f or Outstanding Perf ornnnce Given in Memorv of the late Dr. I{enneth Murray by the Department of Surgerl', St. Joseph's Hospital Presented bY Mrs. S. l{. Hudecki S. E. O'Brien, Chairman, Board, of Dircctors, St. Josefh's School of Nursing CHAIRMAN-Dr. NANCY *O CANADA *OPENING VALEDiCTION GREETINGS - Rercrend. Matthczv Crogan - - - IfrsNancyMannincn - - - Hk Ercellenct' Paul F' Reding' A d m i n i st r o t o r , Diocese of Haniltort Controller Robert M. LIorrou, City of Hatrilton Dr. Jancs B. Osbaldestott, Chairman, Board of Trustees, St. loscph's Hosl,ital, Hamiltott PRAYER TO THE GRADUATES - PRESENTATION OF DIPLOMAS OIr GIiADUATION PRESENTATION Pi)IS - PRIZE Given by the Alunnae, St. Joseph's School of Nursing Presented by Mrs. S. Richards, President JUDITH ,\DDRf1SS TO TI{E I'RES}INT..\TION RECESSIO\AI, Given b1' the faculty of St. Joseph'sSchoolof Nursing PresentedbY X{iss P. Gilbert Sislrr Ann llarslnll, fortncr Dirrclor, S t . - / o s c p l r ' sS r l n o l o f N u r s i t r g FRANK ZUPCIC Srtrr Ioail O'Sulliz'ttn, I)i'cctor, Scltool of Nirrsirrg l I r s . P a t r i c i t O s t af c l n h ' -lssocistc DD'tctor, S clrc ol of -\'itr.rtrt.r7 B L ' R S A R Y A r I / A R D f o r P o s tG r a d u o t cS l r r d l i n \ - u r s i n g Hospital Auxiliarl' Given b1-St. -JosePh's Presentedb1' llrs. H. Patzalek Sislcr 'l1arl Clarc, C S I f , l i ' s sA n t o i n t t l c J l a n c i t t i BL'RSIR]' SPF1AKER - UR:\DU-\'I.ES - SIIIRI,EY ll P ' r'l1r' "!r'rur O'Sulliat' Hamiltou If cntzLortlt A CK A' O'T/L E D GEJI'1EN7..' *GOD S-\VD THtr QUEEN - - , l L f A R D f t t r P o s t - G r L r d u a l cS t r r d - r 'i n N t r s i n g Cliven bl the fleclical Staif. St. -foscph's Hospital I'resentcd bi llrs. J. J. Carroll I)r. JutncsD [io/lor''ar" [: -t'cc rttiz'c D ir(r t or' Sl. -/osc1/i s IIosPital OF .\\\'ARDS - \{ATTHEWS MERIT A'YARD Slcflrctr Srln,urts Oli IIUEST for Genaral Proficicnrt NANCY X{ANNINEN Bridqa oz'cr Trotrblcd LI-ater Stiirrorr 6 Garfunkcl All Good (|tfts I\TRODUCI'fION IVIANNINEN Organist I'anrl of Hoft and Clory -L,dtard Elgar Sistcr l[uriot Sistcr IIart' Clarc, C.S.I. lliss Antoincttc \Iancitti +Stand i,,lrcre indicatcd bt, aslcri.rF Program lor the 50th and final graduation exercisesof the school of nursing. 116 Dot.'ncr, C SJ- ANDERSON tr\{isr M*tgaret Feart graduated from St ioseph'CSchool of,Nursing irr 1944.'After she :tornplslgd post: graduate studies in nursir,lg,education at the University of Toronto in 1946,,Miss,Peartrehrrned to her alma maierto teachfor two )tears. : Between1948and,197S,sheheld a series of administrative positions with the Canadian Red:Cross$qgiety, the school of nursHospital in ing,in Bellbvitle, the htot's Toronto and the RegisteredNursing Association of Ontario. In 1970,sheagain returned to St. Josephs and served as Assistant Director of Nursing, Associate Director of Nursing and Director of Nursing. Miss Pearthasbeenan eyewitnessto the evolution of the nursing profession throughout her distinguished career.Nursing has evolved, she says,into a credible profession. "Since my time as a student in Undermount, I have sem St.]oseph's-Hospitalexpand and growinto the marvellous facility we have today. Changesin rurrsing service and education have kept pace with the changes in the health care delivery system 'Today we have and technoLogyi'she said. a greater emphasis on the psycho-social Miss Metgeret L. Pest aspectof care.The patient and the patient's family are much more involved in the patien(s care now." ln September, 1989,Miss Peart retired from St. ]oseph's as Assistant Executive Director, Nursing, a position she held for three years. f Miss Mery R:ita Leplnskie Mary Lepinskie worked at St. Mis ]oseph's after her graduation from the school of nursing in 19,18and taught in the school as well. OnSepternber 30, 1956,she made history at St. Josepltlswhen she was the first lay person to be appointed Director of Nursing Serviceat the hospital. Three years later, on January, 27, 7969, Miss i.epinskie died suddenly of staphylococcal pneumonia that followed the Asiatic'fhr. She was 41. In her memory, the Mary Lepinskie Library was established in the department of nursing. t tt'l RESTDENCES :rE I he St. losephls nursing residencesover the yea* were Undermount, Marygrove, thC staff residence, Oakbank, Farham fffi,andFontbo*n .,.. -,Thelkst nurses,, ,Uldelg ggqtRCsidence :f,ormer: r,esidinae,.was:,the, hornC,of,Adam BrowrL merchant and politician, at the .cort$1..of..St.. ]oaeph's,&,ive and Mountwood Ave. (thenknown asAlma Ave. and Mountain Drive). To accommodatemore students, the residence was built on the samesiten9n.It hassincebeenreplaced sarase ::"r:--":"Ts . :. Oakbank - The fonner home of Williarn PattersonMclarm, prosperouswholesale grocer from Scotland,on ]amesStreetSouth, built by ]ohn Stinsonin the mid 1850s. Marygrove - Was built in 1869 at the cornerof JamesStreetand St.Joseph'sDrive facing southwest.It was the home of Senator Andrew T. Wood. St.Josept/spurchased Marygrove on September 15,1947,andused it as a residencefor nursing students. In 1960it was demolishedwhen construction of the new surgical building began. Fontbonne - This residence,completedin December, 1952,ts now used for doctors, offices,hospital administration, human re- soutrce$' andthe4gp1ii:1.j oI fi*ance. Drnrcrons oF Sr. Josumr'sScnoor oF NuRSrNcANDNunsrrucSrnvrcr SisterEoaristaBaine MissMnrgaretPeart SisterUrsulaBarry SisterXarier Reding Miss GenwianeBoyes SisterMonica Smythe SisterAugustineCampbell SisterMary GraceStenens Sister Aloysia D earling Sister D ositheusTracat SisterBonaaenture Fagan MissMae Gibson Sistn Virginia Hanlon Sister AssumptionKehoe Miss Mary Lepinskie SisterMartinn Long SisterBernnrdineMadden SisterAnn Marshall (Maris Stella) SisterSt. BasilMcClarty SisterGerardMoran SisterJoanO' Sulliaan(Celestine) * Sister Monica Smythe,Supeintendent of Nursesin 19U. 118 Chapter Twelve THE VOLUNTEERS On May 22,1945,women from Hamilton and areaparishesmet at Undermount, the nursing students'residence,to form the first auxiliary at St. ]oseph's Hospital. Becauseplans for a new hospital were well underway at that time, the women felt that an auxiliary could help meet the expenseof equipment and furnishings. Dances, teas, card parties and bazaars comprised some of their first successfulfundraising events. In subsequent years, auxiliary members setup a patients' library and made substantial donations for the purchase of equipment. br 1957they paid for the installation of a system that provided an immediateand unintemrpted flow of oxygento the patients'bedsides. A volunteer organizationbegan in 1961 and latermerged with the auxiliary to become the Auxiliary Volunteer Association.Its enterprises grew to include a successfulgift shop, family fun days, fashion shows and publishing a cookbook. When the new surgical wing opened in 19625t. ]osephs becamethe first hospital in patientsjammeil any oacant spacearouad the hospital as the steff scarried to bing morc patients ftom the the city to introduce teenagedvolunteers.Mrs. smoke-fill ed buil ding. ConstanceMclean, director of volunteers at the time, approachedprincipals of high schools in in the hospital's vicinity for co-operation in phone line installed in her home for the exclu- pers.Onceit caught on, the idea of teenagers the hospital was well received," recalled Mrs. sive use of volunteer business. encouragingteenagersto volunteer. 'They Mclean. "I resigned as volunteer director in enthusiastic. and wonderful were Mrs. Mclean organized most of the re1964 but I have never had that phone line and cruitment and schedulingfrom her own home. Some girls worked in the emergency The response from 500 teens was so over- admitting departments. Others directed visi- removed." In 1966,443 senior and teen volunteers whelming that she paid to have a secondtele- tors around the new building or folded diall9 donated 30,000 hours. The eve contributed $50,000toward furnishing the hospital's new intensive careunit and increaseda scholarship to $1,000,which the schoolawarded to a graduating nurse for post-graduatestudies . As teachingand training programs broadened, patient care changed dramatically from the early years. Volunteer efforts frequently assistedwith the purchase of life-saving machinery and equipment as the hospital im' oved its serviceto the community. When the AvAwas not busy raising funds, it devised new servicesfor the well-being of patientsand their families. For example,inl970, the group initiated a hostessservice for the benefit of friends and relatives who waited for information on patients in the intensive careunit or surgery. The volunteer hostessesactedasa linkbetween the doctor and the familp helping to allay the family's concerns.Two years later a similar liaison service was established in the emergency department. Mrs. Thelma Maskell beganas a volunteer at St. joseph's in 1970.Today she is director of the men, women and teenagerswho so generously give of their time and talents eachweek fortheimprovement of theservice rendered to St. ]oseph'spatients. Possibly the biggest challenge the volunteers ever faced came in 1980when the hospital closed for two weeks becauseof a fire. At 9:17a.m.on May 1, 1980,smokefrom an electricalfire in the basementboiler room at St. Joseph'striggered a two-alarm fire at the fire department. When firefighters reached the hospital eight minutes later they found smoke billowing from behind a wall and a false ceiling. They hackedat the ceilingbut were unable The Eire Depart nertt had a man posted to uatch the building all that night. to contain the fue, which sent up toxic fumes from burning plastic and electricalwires. All surgical procedureswere cancelledat 9:35a.m. exceptfor two operationsalreadyin progress- onewasa radicalprocedure scheduled for four hours and the other was a total knee prothesesfor almost five hours. Nurses in theseoperatingroomsput wet towelsaround doors to keep out fumes. Forty-five minutes after the fire started, Donald Scott,acting executive director, ordered a complete evacuation of the hospital to begin with the intensive care unit, heart and respiratory patients. 120 In lessthan 90 minutes hundreds of rescue workers had removed the 600patients.Hospi tal staff, policemen and firefighters assisted the patients to parking lots. Forhrnately, although the skieswere overcastthat day, it was mild and dry. Somepatientstook the chaosin stride.One man quipped that "this must be a group excursion" while another thought it was marvellous that the hospital had arranged a sightseeing tour for patients. Others were not quite so philosophical.If she was going to be evicted, one woman wanted to know, why had shenot ing and my office was in a shambles.My main concern,of course,was that the patients were out," she said. Sister Joan took the first possible flight home and arrived at7:30 p.m. at the hospital. At 11 a.m. the first operation was complete, the patient was wheeled out and the on staff evacuated.Half an hour later the second surgeonfinished his operation. When this staff vacatd the entire hospital was empty. The incident promptd one doctor to comment: "This is the first time I have seenpatients put to sleepin onehospitalforan operationonly to wake up in another hospital." Exactly three hours after it started firefighters reported the fire was out and smoke diminished. Five firefighters suffered smoke inhalation but not one patient was injured. As construction workers boarded up windows, Mr. Scott announced that the hospital was closed until further notice. Switchboard operators were allowed back into the building and patientchartsweresentto the otherhospitals. Maternity patients returned to the first floor of the maternity ward which had not Afleet of T7Toronto ambulaflcesircluding Metto Toronto's ambulancebus,utas ilispetchedto Hamilton to help eoacaste St.loseph's. been affected by smoke. It took two weeks to put the hospital back been given two days' notice? Although the truck or fire units. As the result of tremendous in order. By May 14the hospital openedagain, hospital's food servicesdepartmentand neigh- co-operation,St. Joseph'snurses, nursing as- patients were welcomed back and elective bouring residents provided beveragesand sistants and other staff members from St. surgery resumed the following day. of all Struck by the complete selflessness sandwiches,one cranky patient demandedhis Joseph'swere allowed to continue caring for involved in the clean-up Sister Joan comusual noon-day hot meal. their patients at theseother hospitals. 'That includes relatives of patienb As many patients as possible were transBy 10:30a.m.Mr. ScottphonedSisterJoan mented, ferred indoors - to the Church of the Ascen- O'Sullivan, executive director, who was at- who were sent home and who were returning sion and St. ElizabethNursing Home (both on tending a meeting in Calgary. Fifteen minutes hospital dressing gowns in perfect condition John Street),to the FontbonneBuilding and to into the meeting, Sister Joan received a mes- - washed and ironed." On that May day in 1980,Mrs. Maskell had a nearby residenceowned by the Sistersof St. sagethat a long distancecall was waiting. "I joseph. City hospitals prepared to receive rememberMr. Scott telling me that the hospi- reasonto be especiallyproud of the volunteers patients who arrived by ambulance,bus, mail tal had beenevacuated,the fire was still burn- who worked closely with the staff - helping t2l to removepatientsfrom the smoke'filled building assistingpatients on to busesfor transfer to other hospitals and distributing blankets and refreshmentsto those who waited in the parking lot. "The day after the fire, I received a call from McMaster University Medical Centre's director of volunteers. The pediatric patients who had been transferred there were anxious and I was askedto send our volunteers to help allay the childrens'fears. I called the women who usually work in the pediatric unit and without hesitation they agreed to go," said Mrs. Maskell. Two weekslater,asthefirst patients began to return to St.Joseph's,SisterJoanO'Sullivan called on the volunteers to arrange a bud vase for each bedside table as a way to welcome eachof the patients back. [:l 1983, the Volunteer Association presented the hospital with a cheque for $75,000 for the purchaseof equipment,as well asa van to transport equipment to dialysis patients. Thelma Maskell is proud of the successof the diversefundraising activities that the asso- ciation undertakes. "Although fundraising is a primary focus of the association,volunteers are an important part of the hospital's public relations too. For example,we participate in an evaluation program that helps the hospital assessthe quality of care the patient receives. We also assistin palliative careby visiting and listening to patients," she said. "Apart from the gift shop, the associationhas developed new ideas such as gift carts, a Spectatornewspaper delivery service, floral delivery and cradle pictures." Some services started as the result of a simple suggestion. 'nVhen Dr. Galloway was executivedirector, he asked me one day what a gentleman could bring when visiting a woman in the hospital," Mrs. Maskell said. "Toiletries and chocolatedidn't seem appropriate. He suggested a small floral arrangment.Sothe volunteersmadeupabout75bud vaseswith fresh flowers. They were so popular that they sold out within the first hour." The tradition of volunteering has continued to be a successful and vital part of St. Joseph'spatient careprogram. In 1989a total of 435adult and teenvoiunteersdonatedalmost 45"500hours to the hospital. SisterLoretto Ford comforts an at*ious patient, t22 Chapter Thirteen THE HEARTBEATOFST.IOSEPH'S ttT I always count every blessing," says Sister Mary Daniel Weadick. "I had the privilege of being able to work at St.]oseph'sfor so many years. I worked with wonderful staff, nurses and people who did all the humble work. They were magnificent, dedicatedlay people.Every day,I gather them all io -y prayers. "I know that even to scrub the floors in the hospital is special.They're not just any floors. What are we doing all this for? We're doing this becauseof the sick." Sister Mary Daniel, who workd, for 22 years as a nurse in the operating room, offers her own tribute to all St. Joseph'semployees, past and present. It also servesas a reminder that eachemployeemust approachhis or her job in the spirit of the hospital's mission statement - to guarantee quality of care for all patients. The messagehas never been more important than it is today, as an increasing number of lay people carry on the Sisters' work. Apart from offering health services,the hospital is called by its mission to participate in educational programs for all health care staff, the general public, the patients and their families. Clinical, scientificand administrative health researchdesigned to enhancethe quality of health care are included in its educational focus. As part of a system of health caredelivery St. Joseph'sworks in co-operationwith other The chapel openeilon December14,7987usasdesignedby Klaus Design Inc. It emphasizcsa peacefulatmosphere agenciesto meet the needsof the community. and is located near thc front entranceof the surgical building completeil in 7962. r23 The hospital promisesto provide leadershipin health care and to develop innovative programs - such as Pastoral Serviceand Palliative Care. Although SisterJoanO'Sullivan, immediate past executive director at St. joseph's, describes the hospital as the Sisters' "family business,"the concept of a small organization no longer exists.In the past the Sistersinstilled the mission and philosophy of St. joseph's in the staff and nursing school students. Now every staff member is responsibleto know and passon mission values. The Sisterscontinue to ensuretheir "business" keeps pace with the philosophy of modern rnnagement. In 1983, the hospital published an official mission statementwhich explains its general servicesand areasof spe' cialtp affiliations and its hopes for the fuhrre. The statementalso clearly articulates that "as a Catholic Health Care hnstitution, such servicesare provided within the moral and ethical framework of the Catholic Church for persors of all creedsand cultures." BecauseSt.]oseph'sis not contentto merely preservethe status quo, in 1986it established a mission renewal committee representedby individuals from a cross-section of departments which include, among others, house. keeping, nursing, social work and the Sisters' colporation. The committee examined ways that all current and future employees could take ownership of the mission's philosophy and demonstrateits meaning in the work that they do. Always, the goal is to betterservethe patient. One way this philosophy is expressedis in the developmentof a pastoral sevicedepartment. This need becameapparent as fewer Sisters worked in the hospital and there were not enough people to hear the patients stories.In '1,971,, a piest and two Sisterssetupa chaplaincy deparhnent. At that time, they focusedmainly on the patient's spiritual and emotional wellbeing. The department has since grown to include 14 futl-time staff who provide 24-hour coveragethroughout the hospital.Today their services have expanded to help not just the patient, but the patient's family and also the hospital staff who work with them. Sister Kathleen O Neill, 38, is director of the department of PastoralService.In a quiet voice and with carefully chosen words she explains that her staff handlesas many as 600 referrals each month. Her serenity permeates the whole pastoral service department. "As full membersof the health-careteam we focus on the patient's spiritual and emotional wellbeing. Being hospitalized is a time of crisis for the patient becauseof the lossof independence and control over one's own life," she says. "The patient and the patient's family must cope with fears, confusion and often, ethical concerns." "Patientsexperiencea greatdeal of tension beforesurgery, which they can releaseby talking to one of us. It's very hard on famites and friends from out of town when their loved one is a long-stay or terminally ill patient. This is made even worse when family relationships are strained. They need to unite and reconcile themselvesto the sihration," saysSisterKathleen. "We never tell people what they should do but we can help by actively listening,advising and helping them communicatewith each otherand with thedoctorsandnurses.Through r24 our care and concern, we really can enhance the hospital's mission." The pastoral service staff works in every unit in the hospital. 'nVe are present when a patient gets bad news. We help the patients express their questions and fears. Anxious families waiting for a patient to come out of surgery or thosewaiting outside the intensive care unit are never alone," says Sister Kathleen. David Jewell,a socialworkeratSt. |oseph's, says the pastoral service staff contributes a specialvibrance to the hospital: They bring a spirihral concern to the crisis of being admitted to the hospital and they know who is being discharged.They really are the heartbeat of St. joseph's. Dr. Ken Ingham, chief of the department of nuclear medicine in the late 1970s,stimulated interest in palliative care at St. Joseph's: I saw people dyiog in great distress.It was a subjectI was in contact with quite a bit of the time and I realized there were a lot of things that needed to be Iearned about how to handle the dying. Like most other medical people I was ill at ease with a dying patient and knew nothing whatsoever about bereavement,becauseit was not something that doctors had much to do with. somnia, and confusion over complicated medications. Although nurses said they could hrrn to eachother for support to discussthe problems of caring for the terminally ill, they felt a lack of preparationfor palliative nursing.Becausethey spentmore time with a patient, nurseswanted support from physiciansand more time to deal with the problems that arose.Above a[ they expresseda wish to be with their patient at the time of death but were frustrated that other duties often interfered. Physicians revealed feelings of failure to properly diagnose or treat the patient. Their At that point, the best way St. ]oseph's training, they said, focusedon how to treat the could honour its commitment to quality papatient in a medical or surgical - but not in a tient care for the dying was to hold weekly palliative- way. When a patient died, doctors sessionsto discussthe establishmentof a proreported feelings of depression and anxiety. gram of palliative care. "A grouP of people Some experienced nightmares. Others lavoluntarily met oncea week for two years.We mented they did not have enough time to learned and exchanged ideasi' Dr. Ingham spend with their dyi.g patients. said. "It was a type of consciousness-raising As a result of the investigation, a palliative that attracted a number of people. We went to care consultation team was officially initiated knowledgeable. quite conferencesand became in October, 1981.The team is comprised of a Administration got involved becauseDr. Jame part-time physician, a nurse and a social Galloway, our executive director at the time, worker, both full-time, and a liaison person was anactivesupporter of what wewere trying from pastoralcare.When cure or prolongation point where we got to the to do. When things interest it palliatioe Ingham stimulated Dt. Kmneth of life are no longer possible, this team makes needed to do more than just talk about it, we cqte, every effort to improve the quality of time that hired consultant Dr. Donna Mitchell to do a does remain for the patient. survey for us." jane Anderson has been a social worker in The St. Joseph's Hospital Foundation their families and health careworkers all expe' funded the study. "The Foundation was very rienced confusion, misunderstanding, lack of palliative care for almost six years.Caring for much involved. In fact, palliative care would communication and feelingsof failure in deal- the terminally ill, she explains,is an interdisci plinary effort at St.Joseph's."Our department not have gone far in this hospital without its ing with terminal illness. works with all the others. We receivereferrals had not informed the Patientswho been of support. Becauseof its help, we were aheadof other hospitals.And we had people who were seriousnessof their condition were more fear- from nwses, physicians and the pastoral care awareof what was possible,"Dr.Ingham said. ful than thosewho had. Family memberswho staff, among others," shesaid. "But the quality The results of the study - published De- caredfor a patient at homereported feelingsof of carewe try to achieveis for all patients,not cember 20, 1979,- revealed that patients, disorganization, fatigue, lack of appetite, in- onlv the terminallv ill." When a patient died, the relatives went away. My interest was sparked when I attended a meeting at which a paPer entitled nVhat to do when there's nothing else to do' was presented. I learned that doctors had misunderstandings about analgesics,communication and the business of symptom control. r25 ('r Mr* leawtte Gilkes, Exeettipe Director of St.loseph's Hospital Foandaf,isn since 7987. Dt. Joseph'sHospital Foundation had an inauspiciousstart in the mid-1960swhen an astuteSisterput $15of her own money into a fund and simply started talking about 'the Foundation'.Sheencouragedthe establishment of a trustfundas thesolutiontoproviding money for research programs at the hospital. "I put the money away without telling anyone and kept talking about it," recalls Sister Mary Crace Stevens."Eventually it started and now it's a big affair." In 1966the medical director, Dr. james Callowap stimulatedfurtherinterest in what was then known as St. Joseph's Hospital Hamilton ResearchTrust Fund. At that time, he says, a study had just been introduced on aspectsof brain function. Elsewherein thehospital,researchareas included hemophilia, pulmonary function and the relationship of diabetes to heart disease, and the need for funding was be' coming increasingly apparent. A donation from the FirestoneFoundation helped to officially set up the hospital's Foundation in 1969.By April of the following year it had receivedits charter and was incolporated as a charitabie organization. Most of the Foundation's original objectives have not changed:To provide broad, specialized services not already available and to cover programs of health, education and research.The Foundation is managed by a board of directorsand provides money to the hospitalfor needsnot funded by government grants. Mrs. ]"eanetteGilkes, Executive Director of the Foundation since 1987,says that initially the Foundation'sprimary role was to receiveand maintain money for the benefit of the services provided by the facilities owned and operated by the Sistersof St. joseph. fhe Foundation's role has grown to include active fund-raising campaigns and events as well. Recentcampaigns have assistedin offsetting the cost of the 1984building expansionat the hospital and the 1988 purchase of new equipment. A current campaignisunderwayto helpmeetthecosts of the new ambulatory care centre. Mrs, Gilkes says"Fundraising has grown to meet these needs - all for the benefit of the patients at St. Joseph's.We have a dedicated group of enthusiasticcampaignerswho come from all areasof the community." Apart from individual donations made by patientsand former patients,the Foundation also receives money from community groups/ religious organizations, employee groups in locai industries, service groups and schools. t 126 -.r NF (D I H \ S. |! * s s * s (b T |! (1 qr e oi e e + s G s G i:rr s $ E s (a E $ (a F. e (! F !i l- {:r ! (a F s :+ Oa s + 6 s G e (! :i t! \a e d @:. 5s sq S e t (< s s. $ s :r Xt - .,; t U) o T 6 \s\ s E s R. a a E 6 (o oo B \ ;r \ E" *r! $ qs (.: $ i; e { -l |! r! F s s \ o s + + (a N G b ?J + ? s s s oa \;5 sx- F.S l! rt €+i s> ,t i' \oz F\ ('J F F E F G s E s frr s + d s + s^ ss F s e o T a CA t $ li q + to s. d ) ta a l! + x \ 6 s G $ Rta F€ s $ta :-qq :s .s uD s t !:i' [*; -vi k Q-a dtts. (vFt F<O FFS sss :*s ri.((E;I d s€ p3F The example set at St.J.rseph'swas instrumental in the development,in November 1983, of a regional palliative care program, which reports to the Hamilton-Wentworth District Health Council. Also in 1983,through the combined efforts of pastoral and palliative care, the hospital began to hold a service in memory of those patients who died at St. joseph's in the previous month. '"We try to help the bereaveddeal with their grief and let them know that they have not beenforgotten," SisterKathleensays. "Each month there are about 60 deaths at St. Joseph's,so that leavesmany grieving family members and friends. The staff grieves too when a patient dies." On the first Thursday of each month an ecumenicalserviceis held at noon in Fontbonne Hall. Family and friends of the deceasedare invited. Somehave found the service so comforting they continue to attend for several months. As part of the healing process,guests are encouragedto stay after the service,have coffeeand talk with pastoral or palliative care 'nVe can't always cure but department staff. we can show we care," says JaneAnderson. The degree to which the palliative and pastoral care departnents are successful in fulfilling their mission - and the hospital's can be measured by the dozens of letters of appreciation which are received each month. One letter reads: Wewish to expressour heartfeltthnnla and appreciationfor the loaing careand attention shousnto the lnteEric Vardy,our husbandand father,during his stayat St. loseph'shospital. Eric's initial staywasjust oaertwo months Iong.lt u)asnecessary for him to return twice Houaser, cnre. dueto hisexpeience for further thefirst time it was not the druded ordealit couldhaaebeen. Thenursesin thelwadand neckunit on the fifthfloor aretobehighlycommended for their chee(ul,compassionate tratmcnt whichrnnde histraumnticillnesssomucheasierto bear.It is lnr df or ustoput intowordshoutmuchit meant to lnae Eric surroundedby frimds during his last fats doys. Thesefriends were the caing nurses! Eaerything pusiblewa"sdonefor him duin g hisfinal drys to helpus througha aerytryng peiod. Weapprecinteso muchtlw fact tlat ute utereableto bewithhim at all timre. We can't beginto named)eryoneinaolaed because thereweresomnnyandwe would not want to miss onepersoflwho contibuted to Eric's ure. Hmtset)er, tltereare somespecinl peoplewe haveto mention. NurseMaiettaPupowasatouterof straryth to us. Wealwayslomntwe couldcaIIon her at any time.Sheperformed senicesfor Eic during hisfinal stry in thehospitalwhbhwerewer andabouethe line of duty. ShetruIy caredand useloolced on herasafriend. Her constantuisits and thoughtful deedswill alwrys be remembered. SisterKathleenO'Neill's aisitst o Eic meant somuchto him because theymadehisdaya little bighter. He found it soeasyto talkto her. We had thc pleasureof getting to bwut and enjoy her maruellouspusonality. SandyPilatzkcand thc othernursesin tlte unit were cheerfuland friendly at all times. They usentout of tlwir wny to makehim as t3l as possible. comfortable Dr.l. Young,the surgeonwha operatedon Eric did nterything possibleand tied eaery treatmentaaailable.Wewill be eternallygrateful to him for not giaing up on Eric. He is a superband dedbateddoctorand we feel aery fortunatetlwt Erichadthebestsurgeonlooking afterhim. Weareoamllulmed with gratitudeandwant thelnspitalfor lnaing suchan outto commend standingstaffto lookafter thepatients. Again,tlankyou, MerleandRobertVardy The following story from the May,7989, issue of Focttson Nursing, published by the hospital's nursing staff explains how the terminally ill patient is cared for at St. Joseph's: The importance of familycentred nursing care is a concept familiar to all nurses. However, the benefits of family involvement in planning care for the terminally ill patient became all the more apparent for us on 5 Surgical East while caring for Mrs. P. Mrs. P.,a 51-year-oldwoman of Chinese background, was admitted to St. Joseptrjsfor the first time in October 1987.She was in and out of the hospital eight times and had two sur- geries for cancer of the colon. Her final admission was to our unit in September,1988.Mrs. P. was admitted for palliative care and spent her last days before her death (about six weeks) on 5 Surgical East. Mrs. P. and her husband, a minister, have a son and a daughter, both in their twenties. The family had been in Canada for about six yearsand maintained strong cultural ties to their heritage.They were also very religious. The family lived in Mississauga which necessitatedconsiderabledriving and bus rides throughout Mrs. P.'s stay. We encouraged their involvement in both the planning and implementation of her care.Mrs. P. had decided she did not want to be resuscitatedif shestopped breathing.The family members were open with their questions and we tried to ensure all questions were discussedand answered. A palliative care referral was made to assistin caring for Mrs. P. The palliative care team provided emotional support to the family and served as an invaluable resourceto the nursing staff regarding pain control. Drring the month beforeher death, Mrs. P. becameunable to verbalize her wishes so her husband and children became involved in decisions regarding her pain control. At least one family member was with her throughout the 24 hours of a day. They informed us when they felt she needed analgesia and suggestedwhen a stronger analgesiawas warranted. They assistedwith her personal careand were frequently seen reading the Bible to her. The daughter often sang hymns. Nursing staff encouraged and respected these actions becausethey seemed to bring Mrs. P. much peaceand comfort. As she deteriorated and became less responsive,nursing staff provided for Mrs. P.'s increasing physical demands while her family required increasing emotional support. When she died, Mrs. P. had her wish to be surrounded by her family. A month after her death, we received this letter from her familv: While sheusasin the hospital,the lwe and kindnessshousnto her and our family by the doctors,nurses,palliatiuecareteam,pastoral sentice,cleaningand cafeteriastaffall drrply r32 touchedus. You hnaea lwing workteamin the hospitalanduterythingthat thry haaedonefor us will betreasuredin our hearts. Wewouldliketo thankthenurseson thefifth floor. Not only did thry talccgoodcareof our wife and mother,but their supportsustained andencouraged usthroughthelast40 daystlut shewasin the hospital. Thephrasein theLord'sprayer'Thykingdom come,Thy wiII be done on earth as it is in heauen'lns certainlycometrue in your lrtptal. TheP. fo*rly From the day St.]oseph's openedits doors in june, 1890, it has had a mission with a guiding philosophy and objectives. Because the Sistersof St. Josephbelieve that all people are made in the image and likeness of God, they strive to maintain and enhancethe dignity of all with whom they come in contact. Hence their motto: "It is an honour to servethe sick" Levels two and three are devoted to the maternity deparhnent. One floor is painted a periwinkle blue and the other is dusty rose.On In 190, the $5Tmillionbuilding expansionat level two are located beds for pre'partum paSt. Joseph'swill be completed. The staff who tients,an operating room for ceasarian-section have been working from various temporary births, a suite of birthing rooms and a recovery and inadequate quarters around the hospital room. will move into the eastwingatlohn Streetand Bedsfor post-parhrm patients are on level Charlton Avenue. three along with the infant nurseries.Several The physiotherapy department which was are private rooms and all are furnished with locatedin the Fontbonnebuilding auditorium oak veneertablesand cabinets.The maternity is on the ground floor level of the eastwing. A floor has its own gift shop and fresh flower pool, office space and an unprecedented service. amount of room for patient exerciseareamong The clinical teaching unit and beds for its amenities.Occupationaltherapy and the of- medical patients are on the fourth level. ficesfor communication disordersare sihrated nearby. On level one are the endoscopyunit, a 15bed intensive care unit, office space,day surgery, pastoral services,maintenanceand the department moved into the rc; stepdown unit. The noisp disturbing en- Th. "*"rgency vironment of the old lcu no longer exists. first level of the new west wing in 1989.Patient Congestion of aisles with supply carts and bedswere doubled to 30and there is a spacious equipment has been eliminated. Private pa- private waiting room. Servicessuch as fractient rooms, decoratedin warrn pink and buff hrre and X-ray are now located in close Prox'racetrack' design imity to emergency which helps to minimize tones, are arranged in a the transfer of patients for examination or treataround the nurses' station. The rooms are large enough to accommo- ment. Levels two through four house the date the numerous piecesof monitoring equipment that relay essentialpatient information hospital's various laboratories and research to the central monitor in the nurses' station. space.Windows from the labs look out on to Windows look outside to landscaped lawns the slate roofs of cenhrry-old homes along and shrubbery and help to orient patients to ]amesStreetand Charlton Avenue. Prior to constnrction of the west wing the the time of day and the seasotts.Ai*ell, win- clinical chemistry, microbiollaboratories to dows face into the room and allow staff check on patients without disturbing them. ogy, parasitology, virology and pathology, Self-flushing toilets fold out of the wall for the among others - were scatteredin crowded, makeshift locationsaround the hospital. convenienceof ambulatory patients. EASTWING WESTWING r33 Sister loan O'Sulliuan (cmtre) puts c finishing touch sn the west wing corstructioa atith lohn Shea(ig!tt)' Chairtnqry Bo*ril of Trustees. Their consolidation under one roof allows thelabsto servethe hospitalin generalandthe emergency department in particular, with increased efficiency. The new wing also includes administra tive off ices,a library, lecture theatre and conference rooms for laboratory personnel. ST.JOSEPH'SHOSPITAL QUARTERCENTURYCLUB NAME DEPARTMENT YEARS OF SERVICE Miss Helen Hammond Miss MarySullivan Miss Helen Liota Mrs. Helena Palynchuk Mr. Edward Vertaschitsch Miss Agnes Bruch Mr. Robert Eusani Mr. FrankGiammaria Miss Kathleen Gibbons Mr. fohn Hochbaum Miss Geraldine LaBelle Mrs. Elizabeth Moskovskv Mrs. Beverly Kennedy Mrs. Anna Kowalenko Mrs. DorothyRowe Miss Wanda Rychlicki Miss Diane Sullivan Miss Dora Klassen Miss Monica Hogan Miss C-arolKarsten Miss Marlene Keon Mrs. Anne Kilfoyle Mrs. Edith Nehre Mr. Dominic Passa Mrs. Anna Skruzmanis Mr. JackVanDerVeen Mrs. Vivian Cassar SisterMary Daniel Mrs. Irene Hoste Mr. Paul Dimtses Mrs. Ona Dramantas Mrs. Olimpia Eusani Laboratory Nursing Laboratory Getired) PatientsAccounts (Retired) Operating Room Laboratory Food Service AudioVisual Nursing (Retired) Maintenance(Retired) Medical Records S.P. D. Admitting Food Service (Retired) Nursing (Retired) Nursing Nursing Laboratory (Retired) PostAnaestheticRoom Out-Patients Accounting Nursing Operating Room Food Service Operating Room (Retired) Operating Room Radiology Pastoral Service EmployeeHealth Maintenance Nursing Food Service 4',1 r10 39 37 37 36 36 36 36 36 36 36 J5 35 J5 J5 35 341/z JJ 33 JJ 33 CJ JJ JJ 32 J2 J1 51 32 Mrs. Fernanda Ferro Mr. Reginaldfarvie Mrs. Renilda MacNeil Mrs. Lorna Matthews Mr. Martin Nehre Mrs. ReneValvasori Mrs. Irmgard Fichtner Mrs. Margaret Curgnale Mrs. BarbaraGreenlaw Mr. Louis Kormendy Mrs. Astra Milne Mrs. Franca Pietrorazio Mr. FernandoVacca Mr. Arthur Walker Sister Rita Marie Wiggins Miss joan Paterson Miss Aldona Adakauskaite Mrs. Mikalina Aleksa Mr. StasysAleksa Mrs. Birute Antanavicius Miss SarahFleming SisterGiovanni Finoro Miss JoyceHeddon Mr. Herbert Holland Mrs. ElizabethJustus Miss Mary Kelly Dr. RobertMcHarg Mrs. EileenMcHugh Mrs. Marion Purdy Mrs. Margherita Ricci Mrs. Livia Scapinello Mrs. StephanieSkorykStrunkelnberg Mr. EugeneStanczyk Mr. Anthony Spaziani Mr. fames Smith Mr. WallaceBaker Mrs. Fulvia Costanzi Miss Marpret Dooley Mr. Raymond Dunmore Miss Dorothy Forbes Mrs. Juliana Kalmar 134 Food Service(Retired) Maintenance Nursing RenalTransplant Unit Pharmacy (Retired) Pharmacy Nursing (Retired) Food Service Nursing Maintenance Nursing Operating Room Emergency(Retired) Maintenance(Retired)' Pastoral Services Physiotherapy (Retired) Delivery Getired) Housekeeping(Retired) Physiotherapy (Retired) Food Service Nursing PatientsAccounts Admitting Maintenance(Retired) Food Service (Retired) Out Patient Surgery Employee Health Nursing (Retired) Nursing Food Service Laboratory S. P. D. (Retired) Switchboard (Retired) Housekeeping(Retired) Maintenance (Retired) Operating Room Food Service Delivery Laboratory Nursing Food Service 32 32 32 7'.) 32 32 31.3/ t 31 31 31 31 31 31 31 31 3 0 1 /t 30 30 30 30 30 30 30 30 30 30 30 30 30 30 30 30 30 291/z 291/t 29 29 29 29 1> 29 Mrs. Lillian McCabe Miss Phyllis Morelli Mrs. Gerda Ortel Mr. Otto Schweinbenz Mrs. Maria Suffole*a Mr. JamesMiller Mrs. Catherine Agresta Mrs. foyce Gilmour Mrs. Magdalena Lackner Mrs. Aloisia Leitgeb Mrs. Faye MacKenzie Mrs. Gertrude Martin Mrs. JoanPhillips Mrs. Jannadiny Reitsma Mrq. FrancesStaples Mrs. Doris Thompson Dr. Robert Haggar Mrs. Audriss Gull Mrs. Margaret Baldwin Mrs. Guiliana Bisutti Mrs. Irene Desjardins Mrs. Mary Geoghegan SisterMary Grace Mr. Lloyd Kendall Mrs. Joan Knox Miss Maria Kojzek Mr. JamesLeBeau Mrs. Mary Louttit Mrs. Giovina Mancini Mr. Michael Newynnyj Mrs. Gerarda Rock Mrs. MaryStallard Miss Winnifred Walker Mrs. Ona Petrunas Mrs. CatherineRoss Mr. Alexander Cybalski Mr. Victor Gurwin Mrs. Marie Antonelli Mrs. Doris Berry Mrs. Mary Blanchard Mrs. CatherineCampbell Mr. RonaldChapman Otrt Patient Dep. Operating Room Nursing Food Service (Retired) Housekeeping(Retired) Maintenance Linen Service Food Service Food Service (Retired) Operating Room (Retired) Nursing Operating Room Nursing Nursing Nursing Pharmacy Laboratory (Retired) Mail Room (Retired) Radiology Food Service Maintenance Physiotherapy(Retired) Administration (Retired) Maintenance Nursing Linen Service Housekeeping Radiology Housekeeping Food Service (Retired) Nursing (Retired) Nursing Operating Room (Retired) Food Service(Retired) Mail Room (Retired) Food Service(Retired) Maintenance(Retired) Linen Service Operating Room Operating Room Nursery Maintenance 29 29 29 29 29 283/t 28 28 28 28 28 28 28 28 28 28 271lz 271/t 27 27 27 27 27 27 27 27 27 27 27 27 27 27 27 Miss Linda Elliott Mrs. Ida Faccenda Mr. Eric Flowers Mrs. Luise Garczynski Mrs. Emilia Gudowski Mrs. Marlene Hoover Mrs. Florence Iacoboni Mr. Russellfennings Mrs. ElizabethKovacs Mrs. Anna Lupinos Mrs. Anna McConnell Mrs. fean Ostaszewicz Mrs. Donna Pierroz Mrs. Elizabeth Raab Mrs. Venus Stanovich Mrs. SophiaSzomszed Mrs. Filomena Trombetta Mrs. JolanViczian Mrs. Ann Walsh Mrs. MargaretannHanlon Mr. ArthurJohnson Mr. Vytautas Miskinis Mrs. Maria Miszuk Mrs. Martina Mueller Mrs. BeatriceSwiston Mr. ThomasVainauskas Mrs. Anna Vanderheiden Mr. Frank Vert Operating Room Food Service S.P. D. S. P. D. (Retired) Housekeeping Out Patient Surgery Food Service Nursing Housekeeping Food Service (Retired) Nursing Radiology Nursing MailRoom Operating Room Linen Service (Retired) Food Service Food Service Nursing (Retired) Audio Visual (Retired) Maintenance(Retired) Patient Assistance Service(Retired) Food Service (Retired) Food Service (Retired) Patient Assistance Service (Retired) Housekeeping(Retired) Nursing (Retired) Stores(Resigned) The following Club member passedaway in 1989: Mr. GeorgeRendell Maintenance(Retired) 263/+ 263/t 251/s 261/+ 26 26 26 25 135 26 26 26 26 26 26 26 26 26 26 26 26 26 26 26 26 26 26 26 25 25 25 25 25 25 25 25 z5 31 NEW MEMBERSIN 1989 Valerie Bagi TheresaBarlow Ann Blawatt Julita Boyce Mary Branigan Margaret Brown Marie Cmrlec Nina Contestabile Jennifer Hines DerkJansen Diane Kirshenblat fenny Kulaga Patricia McAvella feannette McQuarrie Judith Partington Shirley ftott Camillo Silvestri Therese Tamborine WilliamVann Housekeeping Operating Room Nursing Nursing Out-Patient Surgical Radiology Food Services Food Services Laboratory Maintenance Laboratory Nursing Nursing Pharmacy Nursing Food Services Emergency Pharmacy Respiratory Therapy Members of St. |oseph's Lay Advisory Board formed in 1.952were: 25 25 z5 z5 25 25 z5 25 25 25 25 25 E 25 25 25 25 26 25 JosephM. Pigott Rev.JamesB. Ryan D.C.Gaskin Frank j. Keen E.B.Eastburn CharlesLevinson Emil Dubois J.V.Young Howard Moreau GordonSullivan Dr. W.P.Downes ProfessorH. Thode 136 In 1968,the Board of Trustees replaced the Lay Advisory Board. The trustees who have served on the Board since that time are: Dr. M.A.M. Ali J. Nelson Allan Dr. A.RC. Butson Denton j. Butler Bruno W. Bragoh Dr. G.S.Cameron Sharon Campbell Dr. ]oseph J. Carroll Dorothy Cauley Patricia DeGroote Louise Demers Frank P. DeNardis Robert F. Dilworth N.V. Finnie D. Morgan Firestone A.D. Fisher Dr.J.D.Galloway SisterKatherine Godfrev (Benedict) William Hall Dr. A.G. Hart Dr. D.A. Hitch Dr. B.G. Hutchison Dr. G.K. Ingham Anne H. jones Dr. Gordon A. judge Rev. Kyran Kennedy * Dr. Peter Ifuight Dr. L.E. Kobetz Dr. D.I. Kraftcheck Dr. G.A.Iane Dr. D. Leak jordan Livingston Dr. L. Lorenzi Sister Ann Marshall (Maris Stella) Dr. Robert F. Martin Dr. W.R.P.Matthews Angus McDonald SisterMaura McHugh SisterEileen McKenna Dr. C.A. McKinley Dr. D.W. Mclean SisterRegis Mcl^aughlin Sister|oan Mcloughlin Sister Norine Moonev J. Doran Moore * John H. Moore Dr. Garth Noad AlU. Oakie* Robert J. C/Brien * Dr. S. Edward C/Brien Alfred R. Oliver Kenneth W. O'Neal Geo)'O'Reilly Dr.I.B.Osbaldeston* Sisterjoan CXSullivan(Celestine) lawrence Paikin Robert Pogue E.B. (Ted) Priestner Dr. S.O.Pugsley Dr. N.A. Rizzo Sister Alphonsine Rosenblatt Dr. D. Rosenthal V. JamesSardo Sister BeatriceSchnarr (Gerald) Dr.Ignatius A. Scime ]ohn Shea" Dr.l.I.Shekter james Sherlock Rev. John Sherlock Robert J. Smith Halliwell Soule Q.C. Sister Mary Grace Stevens Allan F. Stewart Judge Gordon ]. Sullivan Michael W. Taylor Vincenza Travale Paul M. Wendling Dr. S.P.Zamora Dr. Angelo Zizzo * served as chairperson r37 ENaproysEsoF Sr. JosEPH'sHosprrnr ASoF DEcEvrsrn31, 1989 ADAMS,ELIZABETH ADAMS,LUCY ADAMS,SUSANNE ADDIS LINDA ADDO,WENDY ADILI, LUCY ADLAM, SANDRA AGBOKA,LORNA AGNELLO,VERINA AGRESTA, CATHERINE AGRESTA,LUCIA AGRq AIDA AGRq ALIE AGRq ANGELO AJANDI,ROSEMARY ALAIMO, LYNDA ALBANESI,VINCENZA ALBANO,COSIMA ALBAY,BEATRIZ ALBAY,WILLIAM ALDRIDGE,SHARLENE ALEXANDE&SHIRLEY ALEXANDRE,NANCY ALEXOPOULOU,IAKOVINA ALFORDSANDRA ALGURE,CHRISTINE ALI,EMAN ALI, MAHMOUD ALKENACHIM ALLANBRENDA ALLAN, LATIRIE ALLAN MIRIAM ALLAN RACHEL ALLEN, PHYLLIS ALLEN, RONALD ALLERTON,DONNA ALMEIDA. ALISON AMORE, CARMELLA AMOS, DOROTHY ANASTASIqNORMA ANDAYA,ERLINDA ANDAYA,LEILA ANDERER, FELITA ANDERSENSANDRA ANDERSON,HELEN ANDERSON,IANE ANDERSON,IOAN ANDERSON,JLINE ANDERSON, MARILYNI ANDERSON,NORMA ANDERSON, PAUL ANDERSON,WAYNE ANDREW,KALINA ANDREWS,DONNA ANDREYCHUK, BARBARA ANDREYCHUK, CAROL ANDRIKOPOULOS,SUSAN ANDRU' DELISA ANGELONE, SILVANA ANGELONI, FRANCA ANONECH, PATRICIA ANTANAVICIUS, BIRUTE ANTOINE,SYBIL ANTONELLI, CINZIA ANTONELLI, MARIE ANTONIADIS, KATHLEEN ANTONILIK, KAREN ANTONUCCI,ANNE ANZIT, MARY AQT.nNqPATRTCIA ARCHBELL,IANE ARMSTRONG,BONNIE ARMSTRONG,JENNIFER ARNOTT, LOREIN ARP. NOREEN ARSENAULI KATARINA ASHENHURST,FRANCES ASHTON,MONIKA ATKINSON,SANDRA AUGE&IULIE AUGUSTYNIAK, DARLENE AUSTIN-MELLON, MARY-LOUISE AUSTIN,VERA AVERYJULIE AWDE,CAROL AXISA, ELIZABETH AXISA,IUDY BABOTH, GEORGE BACI{, LINDA BACHE& MONIQI.JE BACIK,'ANICE BADGEROW,CHERYL BADZIOCH, RICK BAESSO,BARBARA BAFTI, SOPHIA BAGI, VALERIE BAGLEY, ANN BAHADUR, TRAVIKRAMA BAILEY, ANGELA BAILEY, ANNETTE BAILEY, HARRY BAILEY,JACQLIELINE BAILLIE, BONNIE BAIN DONNA BAINBRIDGE, PATRICIA BAKER, BEVERLEY BAKE& HELEN BAKE& LINDA BAKER, LINDA BAKE& RITA BAKER,VALERIE BAKER, WALLACE BALDASSI, ROSALIE BALDIN, LUCY BALDWIN,GAIL 138 BALDWIN,MARGARET BALESTRA, DORINA BALIAT,RACHEL BALKWILL,TAMMY BALL,THELMA BALLOCH,LESLEY BALMADRES, DULCE BALOGFIIACQUELINE BALTZER,BARBARA BAMFORDSHAUNA BANKOVY,MAGDA BANNON,STEVE BANTING,LINDA BARANOWSKI, DIANA BARBADORO, SANDRA BARBER, CLARE BARCLAY,KAREN BARD EILEEN BARDOSSYCATHY BARLOW,PENNY BARLOW,SANDRA BARLOW THERESA BARNES,DARLENE BARRETT, AVRIL BARRETT, THOMAS BARRON,WETTE BARRTSUSAN BART,LINDA BARTENS, MARIA BARTLETT,ANN BARTOLIN,HANNELORE BARTOLOZZI,PATRICIA BARZSO,ILONA BASWICK,STEPHEN BATTY,DEBORAH BAUER,DEBRA BAUER,IRENE BAUTISTA,ARACELI BAYTON{LARK, FRANCES BAZINET,LISA BEALE,ARNOLD BEALE' FRANK BEARDWOOD, MICHAEL BEASLE' PETER BEATTIE,DENISE BEBBINGTON, ANNE BEDARDJANE BEEDIE,ALICE BEEMER, DOUGLAS BEEVERS, DIACQUELINE BEGLEY, DORIS BEH&FTONA BELITA,LYDIA BELL,AGNES BELL,JANET BELLINGHAM,CATHERINE BENNER,PATRICIA BENNETT,BECKYANN BENNETT,MARIA BENNIE,HELEN BENSON,ROGER BERENYI,JANINA BERESH,TWILA BERGMANN,DIANNE BERGSMA, ERICK BERKELEY, OsWALD BERNARDWONNE BERNIER,ANITA BERRIGAN, ELIZABETH BERRY, DORIS BERRYMAN, SHANA BERTIN-MCDONALD, MARGLIERITE BERVOET'LEONNA BESPOLKO, KAREN BETHEL,EVA BETHUNE,JANICE BETZ RITA BEVINGTON, DOROTHY BHANDARI,SEEMA BIANCO,MARIA BIARD MARC BIER,ROSEMARIE BILLECI,GLORIA BINKLEYTILL BIRCTILAURIE BIRD,DANIEL BIRRELL,JOHN BIRRELL,MARIA BIRRELL, PATRICIA BISKUP,ANGELA BISUTII,GUILIANA BITTNE&MAUREEN BIZIO&RICHARD BLACK,ELIZABETH BLACK,HERBERT BLACKJANICE BLACK PAT BLACKBURN,LYNNE BLACKBURN, PATRICIA BLACKWOODAI.JDREY BLACKWOODBRENDA BLACKWOOqJ.PATRTCTA BLAIR,THELMA BLAIS,DENISE BLAKENEY,ELIZABE-TH BLANCHARD,MARY BLANKSTEIN, GWENDOLYN BLAWATT,ANN BLEAKNEI DEBRA BLI.JHM,DONNA BLI.JNT,KERRY BLYTH,RAY BLYTHE,LUANNE BLYTHE,MLLIAM BOAG,GAIL BOATENG,ANNE.MARIE BOATENG,CECILIA BOATENG,JAMES BOBZENER, FRANCIS BOCHSLER, COLLEEN BODENHAM,JOHN BOECKELIZA BOEHLING,DIANE BOEHMFELDBARBARA BOLES, MICHELLE BOND,MEREDITH BONELLA,CHRISTINE BONIN,JANET BONKDARLENE BONNALLIE,JANICE BONTJE,MARILYN BONTJE,TAMARA BOOKLESS,JOHN BOOTH,MARRIE BORG,DIANA BORISUKANNE FRANK BORREGGINE, FRANCES BORSELLINO, BOS,CHRISTINA BOTTOS,ALBERTA BOUCHARD,BERNICE BOUCHER,PATRICIA BOURDONLEEANN BOVAIRDLINDA BOWDIDGE,JO-ANNE BOWEN,ANTHONY BOWEN BERNADETTE BOWEN,IAMES BOWERMAN, MIENNIFER BOWKE&IANET BOWLEY,PATRICIA BOWLEY,VIRGINIA BOWMAN,MICHELLE BOYADJIAN,PETER BOYADJIAN,SUSAN BOYCE,IULITA BOYCE,MARIL\AI BOYD,I.RANKIN BOYD,LOIS BOYD,LINDA BOYE' PENELOPE BOZICK RUBY BOZZELLI,ELISA BRACCIqMARY BRANCH,ANNEMARIE BRANIGAN,MARY BRANTON,RUTHANN BRAZUS,INGA r39 BRCIC,CHRISTINE BREEN,DONNA BREINGAM,MARY BRENNAN, HELEN BRENNAN, KATHLEEN BRENNAN,MARY BRETT, SHIRLEY BREUKELMAN, MARLENE BREWE&THOMAS BREWSTER,HAZEL BREWSTE& WAYNE BRIDGES, SHELLY BRILLINGER, RALPH BRODERICK CHRISTINA BRODIE, PATRICIA BRONOWICKI,IULIE BROSSEAU,LYNN BROUILLETTE,MICHEL BROWN, ANNE BROWN,CARL BROWN, DAVID BROWN, GISELE BROWN,ISABEL BROWN,I. SHERYL BROWN, LOUISE BROWN, LANIS BROWN, LESLIE BROWN, MARGARET BROWN,MARGARET BROWN,PAMELA BROWN,PATRICIA BROWN,ROsEMARY BROWN. TRACEY BROWNE, LEANNE BROWNE,SONIA BROWNRIDGE,NOREEN BRUCH,AGNES BRTIMWELL,SHIRLEY BRUSH,SHEILA BRLIYNS,PATRICIA BRYANE, CATHERINA BRYANT-LUKOSIUS,DENISE BRYANT,LEONA BRYSON,WENDY BUCALqBRANKA BUCH,MAUREEN BUCHALTE&DAVIDA BUCHANAN,LEANORA BUCKLES, LINDA BULL,DENYSE BULLEN,DEBORAH BUNDY,LARRY BUNKIEWICZSOLIDEA BI.JNVILLE, DANIEL BI.'RKE,GAIL BURKE,KAREN BURLOCKSUSAN BURNETT,DONNA BURN' CAROLINE BURNS,LORI BLIRNSTHOMAS BURNSIDE,BRIAN BURR,VIOLA BURSEY,PATRICIA BUTCHART,IUDITH BUTION,RICHARD BUYS,TOAN CAGAMPAN,FIORELLA CAIRNS,ELIZABETH CALBICK INA CALCONI,CAMILLA CALDER,MARILYN CALDWELL,BEATRICE CALLON,SUSAN CALVERIMARYBETH CALZONETTI,LAURIE CAMERACCI,DIANA CAMERON,ARLENE CAMERON,EILEEN CAMERONROSE CAMILLERI,CARMEN CAMILLERI,JANE CAMPANELLA,LAURA CAMPBELL, CATHERINE CAMPBELL, CHARMAINE CAMPBELL,DONNA CAMPBELL, SHIRLEY CAMPOVARI, SANDRA CANNING, PAUL CAPOBIANCO, ANTONIO CAPRETTA, CAROLYN CARDWELL, STEPHEN CARESTIA,MADDALENA CARINqSAMTIEL CARLTON, CLATJDIA CARPENTER,FLORENCE CARRICK, CHRISTINE CARRIGAN, MICHELLE CARRI..NHER9ELLIOTT, SUSAN CARRUTHERS, GORDON CARVALHqOCTAVIO CARVIEL, ERVINA CASAGRANDE, SYLVIA CASE,STEVE CASEY-FITZGERALD GAYLE CASEY,THOMAS CASPERSON,DEBBIE CASSA&VIVIAN CASSELL' DAWN CASSIANI, FILIBERTO CASSIDY,LINDA CASSIDY,PATRICK CASTALDI, PATRICIA CASTELLO,ARLENE CASTLEHANO, MARIE CASTRICIANq SANTINA CASTRq LUNINGNING CASTRONOVq ANTONIETTA CASUCCIO,THOMAS CATTAPAN, LINDA CAVALERI, CARMELO CAVASIN LAURIE CERAVOLqNICOLE CERCONE,EVANA CERNIUKIOHN CHABOT,MICHAEL CHAISSON, ELEANOR CHAPMAN,BARBARA CHAPMAN, DOROTHY CHAPMAN, LORRAINE CHAPMAN,NANCY CHAPMAN,RONALD CHAPMANTREVOR CHARLE'GLORIA CHARLES,NATASHA CHARTER' KRYSTYNIA CHENVICKY CHENG,'ANE CHERNESKY,MAX CHIARELLI, ELAINE CHIASSON, CHARLENE CHINAMBU, ROXANNE CHOI, KYUNG SOON CHOU, ALICE CHOVAZ CHRISTOPHER cHow DoRoTHY CHRISTIANSEN, EUSE CHLING, SHIRLIE CHURCH, BARBARA CIALINI, ROsINA CIANCONE,LISA CICHY, MARIA CIMINO,LEONORA CIPRIANI, ROBERTA CLAI& PEARL CLAIRMONT, COLLEEN CLARK, DEBORAH CLARK,IANEI CLARK, LYNNE CLARK, PAI.JLINE CLARK, WENDY CLARK, MLFORD CLARKE, ENID CLARKE, GEOFFREY CLARKSON, MARION CLARKSON TERRI CLAUS, GRACE 140 CLAYTON, ROSALIND CLEGG, PATRICIA CLELLAND LYNDA CLINE, KATHRYN CMRLEC,MARIE COCHRANE, ELLEN COCKSHOTT,COLINA coLE HEATHER COLETTq FERNANDA COLLIER, CAROL COLLINGS, ANNE COLLINGS, LEE COLLTNGWOOD KATHERTNE COLTART, NANCY COLTERMAN,INGRID COLTON,PATRICIA COLUMBUS,MICHELE COLWELL, PATRICIA COMERTON,JOHN COMPACNA, HERMANCE CONCORDIA, ELZABETH CONLON,IRENE CONNELL, BARBARA coNNoLLl HELEN CONNOLLY,TAMES coNNoLLY,IOHN CONNOR, EDWARD CONNOR,SARAH coNRoYPATRICIA CONTESTABILE,NINA COOK, DONNA COOKE, RUTH COONS, ANNE MARIE COOPER,BRAD cooPE& rRENE cooPE& SHERRI COPLAND,ALISTAIR CORBETT, CAROLINE CORDEAU,ELSIE coRDNE&ANDREW coRMrE& ANTONIETTA CORRIGAN,PENELOPE CORSINI,ANNA-MARIE CORSINI,LMICHELE CORTINA,MARGARET COSENTINO, LISE COSGROVE DIANNE COSTANZ,FULVIA COsTANZO,ED COSTIE,ANN COUGHLIN MICHAEL COI,JLOMBE, PATRICIA COUTURE,ELIZABETH COUTI.JRIER, BRIAN COVER,MELROSE COVERLY,CHRISTINA COVINGTON,VICTORIA COWAN,BERTA COWAN,WILLIAM COWDEN,NOREEN COWDEN,SHEILA COWLEY,STEPHEN COX MARYIO CRAN,STEPHANIE cRANtLTSA CRAWFORDCAROL CRAWFORqIEFFREY CRAWFORD,LOUISE CRAWFORD,SANDRA CREA,VINCENT CRE4ELAINE CREWSON,DONNA CRLIENGAIL CROFT,EVA CROFT,LESLEY CROFT,VICKI CRONE,KATHERINE CRUGNALE,MARCARET CRI.JMP,SHARON CRUSTOLqANNE MARIE CIJFFARqJEAN CIjLLEN,LILLIAN CULLEN,RACHEL CULLEY,JEAN DAVI'BARBARA DAVI'GAIL DAVIS,MARILYN DAVISON,PHYLLF DAWSON,HILTRI.JD DAWSON,MARIE DAWSON MARILYN DAWSON,RUTH DAWSON,SUSAN DE BLY,ADITZA DE MERCHANT,IVY DE SANN' LISA DE'FRIAS, LUCIA DEANCIINITHIA DEAN,PATRICIA DEAN,PATRICK DECO6TE,ANNETTE DECOSTEIRENE DECOSTE,PAUL DEFEO,MICHELE DEHGHANI,IULIA DEIONG,KRUTH RALPH DEKETELE, DELBELLO,MARIA DELEEUW,ANDREW DELFINE,ADELINA DELIIA,RUDI DELLAVENTURA,ANNA.MARIE DELLIO,LOUISE DELLOSO,ROSEANN DELMORE.BETTY DELOTNNVILLE,CARL ELENA DELROSSO, DEMASCIO,TANE-T DEMATTEO,SUSAN DENARDIS,BARBARA DENARDIS,RONALD DENAL]LT,SHEILA SUSAN DENBURG, DENNENY,HELEN DENOMMECATHY DENSMORE, CATHERINE CULLEY,KEITH CI.JLLIgNLYNN CULNANE,IOAN CLIMMING-BRADT,KRYSTYNA CUMMING'JUNE CUMMING' MARY CUMMING' SANDRA CURNEW,WENDY CURRIE,IOANNA CI.JRRIEMARY CTIRRIEMONA CURRY,GRACE CURTg FRANCES CVETAgSHEILA CZACH,CHRISTINE CZUM,WINNIFRED YADDARIO, DEBBIE YAGOsTIN,PATRICIA DAGOSTINO,THERESA DAMICq GIOANNE T/AMORE,GIOVANNA DANGELO,SUSAN DTIPPOLITO, LUCIE DA SILVA.MARGARET DACOSTA,IOHN DADA,JODY DAGENAIS,LOIS DALIPE,LILIAN DALLAIRE,LATIRETTE DALPETZ-MONTAGLiE, BARBARA DALY,THOMAS DAMORE,IANE DAMSMA,ANNITA DANEKZULMIRA DAOUST,CLAUDETTE DARLINGTONLYNIN DASILVA"KATHERINE DASTOUS,LORRAINE DAVIES,IOANNA DAVIES,IEANNETTE DAVIES,LINDA t4l DEPAUL,VINCENT DEROCHE-BORIN, LINDA DERUSHIE, MARYELLEN DESANTIS, DORIS DESANTIS,ITALIA DESANTIgLYNNE DESFORGE'MONIQUE DESJARDINS,IRENE DEVAY,CAROL DEVEAq JGANN DEVLINEDWARD DEVLIN,JOHN DEVUYSINANCY DEWIT,ANGELA DI CIENZO,VTTTORIA DI LABIO,ELDA DI PASQUALE, DOMINIC DIAMONDGI.IY DIBATTISTA, LIVIA DIBATTISTA, LORRAINE DICAMPLI,CONCETTA DICENZq PASQUA DICIOMMO,PATRICIA DICKENS,LOUISE DICKIE,KATHERINE DICKINSON,HILDA DICKINSON,MARLA DICKSON,DEBBIE DICKSON,RUBY DIDEMUS,CATHERINE DILLON,PAULINE DILWORTH,GREGORY DIMTSES, PAUL DINARDO,LISA DINELLqJOSEPHINE DINGLEDINE,SANDRA DrNrcoLANTONrg JOHN DTNTCoLANTONIqPTA DIPAOLqJANET DIPASQUALE, TERESA DIPIETRO, LINA DISANZA,CARMELA DIXON,BARBARA DIXONCAROLYN DIXONGILLIAN DIXON MARY DOAN JUDITH DOANE,RANDALL DOBBIE,RI..TTH DOBBINEILEEN DOBSON,CAROL DODDS,VERA DOGANPAMELA DOHANIK LISA DOHERTY,CATHERINE DOHERTY,MICHAEL DOLCH,DOROTHY DOMLADOVAC,BARKA DONISON,DOROTHY DOODY,CARMEL DOOLEY,MARGARET DORAZIO,CATERINA DORICKI,MARIJA DOSLEA,BRENDA DOUCETT,FRANCES DOUGHERTY,LYNN DOUGLAS,KAREN DOUGLA'LINDA DOVE,LALIRALEE DOWELL,JOYCE DOWNEY,SUSAN DOWNIE,BONNIE DOYLE,WINIFRED DRAMANTAS,ONA DRAZENOVICH,ZORA DRISCOLL, DAWN DROTA&DEBORAH DRUMM,PATRICIA DUARTE,MARIA DLJFFY-KARIAIVI, KELLY DUFRESNE, HELEN DUMAIS,MARIE-LOUISE DI.'NBA& ADRIENNE DUNBA&BRIAN DUNFIELDLOIS 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MCNEILL,COLLEEN MCNULTY,ANGELINE MCPHEE,SHELAGH MCQUARRIE,JEANNETTE MCQI'IEEN BARBARA MCQUEEN,ROSE MCQUILKIE,SHIRLEY MCQUILLENCATHERINE MCROBERT, VANESSA MEDEIROS, CATHERINE MEGO,LORETTA MEHLENBACHE&MARILYN MEIKLEIOHNLOUISE MELANEY.VERONIKA MELANSONCHRISTINA MELANSON,MARK MELANSON,NORINE MELCE&TERESA MELHADO,TACQUELINE MELI\M(, NANCY MENDM,JEAN MENDOLIA,ROSE MENDOLIA,SAM MENDOZA,CARLITO MENDOZA,ELVA MENS,MARY MENZIES,DONALD MERINCHUK,BETTY MERKLEY,VALERIE MERRIOTT, DENISE MERWALDREGINA METCALFE,CAROL METCALFE,GLENNA METZGE&VICTORIA MEUCCI,RAFFAELA MEVILLECRYE&SHARON MEYE&ANIA MEYE&DONNA MEYRINK SHEILA MICHAEL'RAE MICKELOFF, ANNA MICLILAN,IANICE MIDGLEIMATIREEN MIKE, DONNA MIKICH, NANCY MIKULA,GRETHA MILANI,CHERYL MILANOVIC,IRENE MILCZAREKEWA MILERIS,RAMONA MILLA& DIANNE MILLE&JI.JLIA MILLER, MELVA MILLS, LINDA MILLSP, TERRI MILNE, ASTRA MILNE, MARY MINARD, ELIZABETH MINGq HORACE MINICUCCI, RAFFAELA MIRANDA,KAREN MIRRA, ANGELA MISCIONE, LAURA MISENE&JOAN MISENER,TRICIA MITCHELL,GRACE MITCHELL,HELMA MITCHELL,JOAN MITCHELL, MARGARET MITRA, BHAVANIAMMA MITTONMAUREEN MOCIAK, ELIZABETH MOGAN, KATHLEEN MOGAVERO, HEATHER MOHORUK, LAWRIE MOHORUK, MARGARET MOLINE,IANET MONACHELLqMARIE MONAS,IRENE MONETTE, DEBORAH MONKHOUSE, ELLEN MONKLEY, DEBRA MONKMAN, LORI MONTAZERI,MITRA MONTEIRqKAREN MONTEMURO, MAUREEN MOODYKIMBERLY MOORE, MAIJREEN MOORE,MICHELE MORDEN,IACQTJELINE MORELLI,PHYLLIS MORES,MAI.JREEN MORGAN, FRANCES MORIMOTqCOLLEEN MORLEY, CONSTANCE MORREALE,NINA MORRIS, CAROL MORRIS,MONICA MORRTSON PETER MORRISSEY,MARY MORROW,SHARON DIANE MORROW SHARON MOSKOVSKY,ELIZABETH MOWBRA'HELEN MOWBRAY, HEATHER MRMAKCATHY MUCCINI, FILOMENA MUEHLGASSNE& HERTA MUEHLGASSNER"HORST MUI&IRENE MUI&SCOTT MULDOON,VELDA MULHOLLAND,MARY MULHOLLAND MARY MULHOLLAND STEVE MULLIGAN-PARKER, SUZANNE MULLINANGELA MUMMERY,DEBORA MUNRO,KATHERINE MURETIC, ANNIE MURPHY,BRENDA 148 MURPHYGEORGIA MURPHY,JOSEPH MURPHY,KEVIN MURPHY,MARY MURPHY,TAMARA MURRAY-SMITH, PATRICIA MURRAY-WOODJOAN MURRAY, BETH MURRAY, MARIE MURRAY, PETRONELLA MURRAY, WILLIAM MURTAGH,MARY MUSGRAVE, PATRICIA MUSICKPATRICIA MUSI ENDLA MUTTON, SHERRI MTryS, SARAH MYSZKOWSKI, GREGORY NAGY,ANGELE NAHAL,KALWANT NALASCO, SHIRLEY NATES, ELISABETH NAVES, CAROLYN NAYLOR.TIMOTHY NEALE,JACK NEHRE, EDITH NELSON,TOSEPH NELSON PAUL NELSON, PAL'LINE NELSON, SYLVIDORA NEMETH, SR ETHEL NEUMAYE&TAMMY NEWMAN-MOLLOY, GAIL NEWPORT, MARGARET NEWTON, LYNDA NEWTON, NANCY NICHOLSON, BAERBEL NICHOLSON, WILLIAM NICOLETTI, ROSE NIEDERE& LOUISE NIELSEN GISELE NIEMEYE&TRIENEKE NIEWIADOMSKA,JANINA NIEMADOMSKI,ZOFIA NIRO,IODI NOFTLE,DEBORAH NOGAS,DEBRA NOONAN,ANN NORDSTROM,MARY NOTq AGNES NOTT,IRIS NOTT,STEVE NOVAKOVIC,JOVANKA NOWICKI,MARY NOWOSIELSKI,T'RSZTILA CTBOYLE, ELIZABETH C/BRIEN,BONNIE CTBRIEN, PAULA C/CALLAGHAN KELLY C/CONNOR"BARRY C/CONNO&CATHERINE c/coNNo&IANE C/CONNOR,MAUREEN O/CONNOR,NANCY C/HARA,PATRICIA C/HARE,GEORGE C/NEILL,JOHN C/NEILL,KATHLEEN CTNEILL,LORETTA C/SI.JLLIVAN, ANNE C/SULLIVAN,ELIZABETH O/SULLIVAN,MIMMA C/SULLIVAN,MARY 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CHRISTOPHER RANDALL, LINDA RANDAZZO, BRENDA RANDAZZO,CARLA RANDAZZqVINCENT RANDLES, ROSE RANGER, MARGARET RASZEWSKI,IRENE RAUNER, ALPHONSE RAVIDA, ANNA RAY, ELIZABE"IH RAZEK PATRICIA REAUME, BRENDA REAUME,MMELINDA REAY, MAUREEN RECZYNSKI, TINA REDMONDBARBARA REES,CYRIL REES,DIANA REEVE,BRENDA REEVE,KATHLEEN REEVE,SANDRA REEVES,BONNIE REEVES,SANDY REIDCHRISTINE REID LILLETHE REIDLORI REID,WILLIAM REITSMA,IANNA REMY,MARY REVILL RICHARD REVILL, SANDRA REVILL, SHERRY REYNOLDS, DOROTHY RHODES,DEENA RHODES, LAWRENCE RICCI, MARGHERITA RICE,RUTH RICHARD,RUTH RICHARDS,ESTELLE RICHARDs, KEN RICHARDS,LORI RICHARDS,NELLIE RICHARDS,ROBERT RICHARDSON,CHERYL RICHARDSON,MARION RIDDIOUGH, DEBORAH RIDDLE,SHEILA RIDEOUT,MARIE RIDGE,FRANCES RIEDEL,MARGARET RILEY KELLY RTNCOVE&ARNOLD RIOIIX, BARBARA RISELAY, WENDY RISIDORE,SHARON RIVERS,GERALDINE t50 RIVERg MARY RIZZO,LISA RIZZO, MARYANN RIZZO,PAUL RIZZO, ROSANNE ROACH, PATRICIA ROBB,MARGARET ROBERTS,ALISON ROBERTS,LOTIISE ROBERTS,LINDA ROBERTS,SUSAN ROBERTSHAWKAREN ROBERTSON COLLEEN ROBERTSON,KIMBERLY ROBERTSON,LALIRENE ROBERTSON,TERESA ROBICHAUD,IDA ROBINS, DIANE ROBINSON, KATHRYN ROBINSON,LINDA ROBINSON, MARGARET ROBINSON,SANDRA ROBINSON,SHARON ROBINSON,SHARON ROBITAILLE,ANNE ROBSON,CATHERINE ROCCHI,CANNE ROCKSARAH RODGERS,DORRETTE RODGERS,KEVIN RODNEY, BERNICE RODRIGUES,ANTHONY RODRIGUES,LORRAINE ROE, LORRAINE ROGANO, LEE ROGERS,JOSEPHINE ROINIC, DONNA ROMAN,GAYE ROMANIWKATHLEEN ROMANO, KATHERINE ROOPNARINE, SLIRUJDAI RO' FADIA ROSALES, AIDA ROSART,LINDA ROSATI,ANGELA ROSATI,MARILYN ROSCOVICH,IANET ROSE,TANICE ROSEN,BARRY ROSENBLUM, MELANIE ROSIANA,MARIA ROSS,CAROLE ROSS,IANE ROSSI,MARIA ROSZEL,BARBARA ROTHY,ELIZABETH ROUGHLEY,BEVERLY ROUKEMA,RUBY ROWAT,IUDY ROWE,DOROTHY ROWE,SHARON ROXBURGH, ELIZABETH ROZICH,MARY RUDD DENNIS RLIPIKCATHY RUSHBROOKJAMrE-LYNN RUSKAI,EUFEMIIA RUSSELL, ANITA RUSSELL, DOREEN RUSSELL, KATALIN RUSSELL, NANCY RUSSELL,WAYNE RUST,IANET RLTTHERFORq CHERYL RUTTAN-SIMS, NICOLE RUTTEN,VERONICA RYAN.HACKETT,MALVERN RYANCOLLEEN RYAN IUDY RYCHLICKI,WANDA RYCKMAN,WENDY RYDE&LINDA RYPMA,WILMA SA,MARIA SABADOS,ALIDREY SACCHINI,ANNA SAUA,SUSAN SAKALAUSKAS, FRANCINE SALAMA,SAMIH SALASTOWITZ, LUCILLE SALINAS,ELISE SALMON,IEANETTE SAMPL,MONICA SAMI'SON DOUGLAS SAMU,MARGARITA SAMU,MARGARTTA SANDERSON, GAIL SANDILANDS,CHARLENE SANDO&GAIL SANDOWSTEVEN SANFORDIULIE SANTARELLI, MIRIAM SANTONE,JLIDITH SANTOS,ESTER SANTOS,LORRAINE SANTOS,ZENAIDA SANTUCCI,EMILY SARTO&GRACE SAUNDERS, COLLEEN SAWE,BRENDA SAVAGE,ANGELA SAVAGE,DAVID SAVEI.LI,JO SAVILLE,KATHY SAWATSKY, DEBBIE SBRISSA, MARIA SCAPINELLqLTVIA SCARROW, LARRY SCATTOLONMARTA SCHEMMER,JEAN SCHILTE,CAROLYN SCHIRRIPA,PAULA SCHLETT, LEAH SCHMIDT,CATHY SCHMITZ,EILEEN SCHNEIDE&JOHN SCHOENFELDT,DARRYL SCHOLES,CAROL SCHOLES,CORY SCHROEDER"ELIZABETH SCHWEINBENZ CAROL SCHWEITZE&JOY SCIASCETTI, SUSAN SCIME,LILIAN SCIME,PATRICIA SCIULLqMARIA SCOBIE,SUSAN SCOLLARD DEBORAH SCORDINO,KATHERINE SCOTT,DIANNE SCOTI,DONNA SCOTT,HELEN SCOTT,MARY 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CHERYL SMITH, DOLORES SMITH, DIANE SMITH, EARLA SMITH, EARLA SMITH, E DAVID SMITH,IEAN SMITH,IANE SMITH,JOYCE SMITH, KAREN SMITH, KRISTEN SMITH,LYNN SMITH, MARY SMITH, MARIA SMITH, PATRICIA SMITH, ROSELEE SMITH, ROBERT SMITH, THERESA SMUK, SHIRLEY SMYTH,IOAN SMYTHE, DIANE SNIDERMAN, PAMELA SOAMBOONSRUP,SIRIWAN SOLIVERE,IRENE SOLOW, MARYLOU SOMERSETT,ARTHURLYN SOMMER' LOIS SOMMERVILLE, KATHLEEN SOOLUM,YENHING SOROKOWSKY, LOUISE SOUTHON, ANNA MARIE SOWDENSHARON SPADAFORA, ANNA SPADAFORA, NATALE SPADAFORA, SYLVIA SPADANqANNA SPADEMAN,JILL SPARK' LESLIE SPEARS,CONNIE SPEIGHT,LYNNE SPELLER,SUSAN SPENCE,ADORACION SPENCE,SUSAN SPENCE&VERNA SPENSER,ANITA SPICER,CINDY SPICER,LORETTA SPILE& ANGELA SPILOTRO,MARIA SPINA, CAROLINE SPINA, DOLORES SPIRKA,IUSTINA SPRAG,IEFFREY SPRAGGONNOREEN SQTIIRE,EUFEMIA STJAMES,HELEN ST LAI.JRENT, LUCIEN STPIERRE,ANNETTE STPIERRE,MICHAEL ST.JEAN,ELAINE STABILE,ANNA STACH,NANCY STAFFORD, ROYDEN STAIR9 MARILYN STALEY DIANA STALLARD, MARY STALLARD, MICHAEL STANEFF,EVA STANISZ LYNDA STANKUS, VIDA STANOVICFI,VENUS STANWICK LESLIE STAPLES,FRANCES STARESINIC,VIKTORIA STAUBE& MARY STEC,HELEN STEELE,BRENDA STEELE,MICHELE STEELE,PAUL STEELE,PAMELA STEELE,TERENCE STEEVES,CHRISTINE STEEVE' DARLENE STEEVES,JOANNE STEFANEC,MARIA STEINE&JUWAL STEKMARY MARIANNE STEPANEK, STEPHAN,SHARON HELI STEPHENSON, STEPHENSON KATHERINE BONITA STEVENS, DONALD STEVENS, LORRAINE STEVENS, STEWART,JOYCE STEWART,LARRY SUSAN STILES, STIT'SIT'IENNIFER STIRLING,BARBARA GEORGINA STOGIOS, STOLWORTHY,WONNE STONEHOUSE,IEFFREY STOPYN,IACQUELINE STRAUGHAN,NANCY STRAUGHAN,VULLIAM STRECZEKCHRISTINE STROUD,KATHLEEN DIANE STURROCK, STYAN.VIRGINIA DIANE SULLTVAN, SULLryAN,MARY SULLryAN,NANCY SUSZEK,IRENE BARBARAANN SUTHERLAND, SUTHERLAND, CHRISTINE SLNLICH,MILLIE SUVA,NIEVES SWEENEY, FLORA HELEN SWEENEY, SWEENEY, ROBERT SMCK,GRACE SMERENGA,TWYLA SYKULA,JADMGA SZABO,BRENDA SZABO,HELEN SZAB0,SANDRA SZALAY,MARY SZALAY,NANCY r52 SZANTO,IOHN SZPAKOWSKI, ELIZABE"TH SZPIRGLAS,GINA TABONE,WILLIAM TAI, DAVID TAI, FLORENCIA TAKAOKA,JOANNE TALACH, RENATA TALBOI LISA TAM,CARMELA TAMBORINE, THERESA TAPUSKA, BETTY TARBUTT, MARY TARPOS, RITA TARSWELL, NEIL TAYLO& CAROLE TAYLOR, KATHERINE TAYLO&NADINE TAYLO&SANDRA TAYLOR,SUSAN TAYLOR,VALERIE TEGZE,ILONA TEGZE,IULIUS TEMPEST,LARRY TEMPLETON, KAREN TERHLJAN, STEPHEN TERRANA,OLDYNA THAN,SHIRLEY THEAL, KENNETH THERRIEN, LAUREL THOMAS, DEBORAH THOMAS,DOROTHY THOMAS, HELEN THOMAS, SARAMMA THOMAS, WILLIAM THOMPSON,CHAI THOMPSON,DORIS THOMPSON, JEANETTE THOMPSON,JOYCE THOMPSON,MARY THOMPSON,VICKY THOMSON,CATHERINE THOMSON,DORIS THOMSONDOROTHY THOMSON,KIMBERLEY THOMSON,LISA THORNHTLL,IOYCE THORPE,ENA THORPE,ROSEMARY THI.JRSBY, DENIS TIERS,KATHLEEN TIMOFEIEW, CAROL TIMSON COLLEEN TITCHNER,MICHAEL TKACZYK,ANDREA TOBIAS,LINDA TOKE,ELIZABETH TOLHOEK,CATHERINE TOLL,SUSIE TOMASIN,MARY TOMLINSONELLEN TOMLINSON,IANICE TOPALOVIC,LUCY TORRISSE, FREDA TORRISSE, MICHAEL TOTH,MICHAEL TOWNSENDSHIRLEY TRACEY,MICHAEL TRACEY,MARGARET TRAFFORDDIANE TRELEAVEN, SHARLEEN TREMBLA' GERALD TREVASKIS, TERRY TREVISAN, GIROLAMO TREVISANLPATRICIA TRICKETT, DEBRA TRIEMSTRA, CAROLYN TROIAN WANDA TROMBETTA, ANTONINA TROMBETTA. FILOMENA TROMBETTA, PETER TRI.]ESDALE, VTVIAN TSIANOU,AFRODITE TLTNG, GURCHARAN TLINIIC,VESNA TUOMALA,KATRI TUOMALA,RIIKKA TUPHOLME,MARIA TUPPE&KAREN TURNBULL,DOROTHY TI.]RNBULL, DIANE TL]RNE&AUDREY TURNER,FRANCES TI.JRNER, LEONA TI.JRNER, PATRICIA TURNE&STEPHAN TURNEWITSCH, VERONICA TURPIE,FIONA TI.JRZAN,LIVIA TWEEDIE,HELEN TWTLHAA&]OANNE TYGHE,EVELYN TYLE&LOLnSE TYMCHLIK,JENNIE TYRRELL,ORETHA UGCENTI,LINDA TILLAH,BETTY UMETSU,CHERYL UNGARO,SUSAN UNIYAL.BACHCHI UNRUH,NANCY UPSON,SHARON UPTON,PATRICIA VACCA,DEBBIE VACOVSKY,MILUSKA VADAS,CARLA VAGO,NANCY VALVASORI,PAUL VALVASORI,RENE VAN ASCH,HENDRIKA VAN DEMARK,HELEN VANDERVEENIACK VAN GEMERT,CATHERINE VAN GRONINGEN,ILDI VAN HOEK, WILLIAM VAN KLEEF,D ROBYN VAN LEELIWEN,MARTHA VANDENBOS,LINDA VANDENBURG, MARTINA VANDERBENT, SUSAN VANDERKOOY, CAROL VANDERKOOY, CHRISTINA VANDERLINDEN, BRENDA VANDERWAL, ANDREA VANDERWAL, SHELLEY VANHOEKDANIEL VANHOEK,TOM VANN,WILLIAM VARCA.IOANNA VARRASSO, ALFREDO VARRASSO, SARAH VASSALLq IDA VAUGHAN,DANIEL VAUGHAN,MARY VECCHI, ANTONETTA VEDELAGO, ANNETTE VEENSTRA,BARBARA VEITCH, HERMINE VELLA, LUCY VENERUS,EGLIS VERARDO, ANNE-MARIE VERMEER.MIREILLE VERMETTE,SUSAN VERMEULEN, LISA VERNONITILIE VERSACE,IANIECE VERSTEEG,MARY VERTASCHITSCH,EDWARD VERTATSCHITSCH,JOSEPH VERTICCHIO, WENDY VESPRINI,DONNA VICZIAN,IOLAN VILLABROZA, ARACELI VILLANI, RITA VILLEMLIRE, LILIE VILLENEWE, CHRISTINE r53 VIRK,BALLVIRO VOLKERS,]AN VOLTERMAN,TERESA VOON,VIOLET VOS,CATHERINE VOWLES,BRENDA VOWLES,KEITH VUDRAG,IVA WAGSTAT', ROBERT WAITE,GUY WALCZAK,NANCY WALIHURA,MARY WALKE& HUGH WALKE&MARY WALKER,MELANIE WALKER,TAMMY WALL,MARGARET WALLACE,EDNA WALLACE,ELIZABETH WALLACE,JEANNY WALLE&JOHN WALLS,LYNN WALMSLEY,THERESA WARD ELIZABETH WARREN,JOSEPH WARREN,KAREN WARTENBERG, EILA WASSER, BRENDA WASSER, GERALDINE WASYLYSHEN, AMELIA WATSON,KENNETH WATSON,LESLIE WATSON,SANDIE WAUGH,LILY WEATHERLEY, LUCIA WEBB,MICHELE WEBBER-CALLAGHAN, PATRICIA WEBBER, CINDY WEBER,MARNIE WEGENE&PETER WEINHOFE&JOHANNA WELCH,SUSAN WELLSTOODHEATHER WELSH,AGNES WELSH,IANICE WENSLAWEKGERTRUDE WERBOWSKY,IOAN WERESCH, RUBY WERNE&MARJORTE WEST,GAIL WESTCARR, DAPHNE WESTCOTT, DEBRA WESTENBERG, DIANE WHALEY,MARGUERITE WHNE,ANN WHITE,ANTONIETTA WHITE,CAROL WHITEHOUSE, BRUCE WHITEHOUSE,IUNE WHITEHOUSE, KEVIN WHITEHURST, PATRICK WHITFORD,TAMMI WHITING,KATHLEEN WHITTAKER,DOROTHY WHITTAKE&IULIE WHITWELL,DIANA WHITWORTH,RUSSELL WHYTE,IUDITH WICKEN'PAUL MELGUS,PATRICIA WIGHARDT,ZOLTAN MLDE, SHARON WILHELM,MARY VVILKCINDY WILK MARYANN WILKIN}DUFFIE,TERESA MLKIN' ANNETTE WILLASCHEKLOLITA WILLIAMS,BARBARA WILLIAM' DEBORAH WILLIAMS,KATHLEEN MLLIAMS, LORRAINE MLLIAM'SONIA WILLIAM' TERRI-ANNE WILLIAMS, VERA WILLIARD MARGARET WILLIARD WAYNE WILLOUGHBY, CLIFFORD WILSON,COLIN WILSON DIANNA WILSON,GERALD WILSON,IEFFREY WILSON, LORETTA WILSON,MARYANN WILSON, PATRICIA MLSON,THOMAS WINARSKY, STEPHEN MNDELER PATRICIA WINN, NANCY WINSTANLEI CAROLYN MNTER,ARTHUR WINTE&MARGARET WOEHL,DIANE WOLF,ANN WOLPERT-ZUR,ADELE WOLSLEI CATHERINE WONG, BETTY WONG, BENEDICTA WONG,CASSANDRA WOOD, DONNA wooDCRoFT,JGANNE WOODHALL, FRANCIS WOODS,KATHLEEN WOODS,MARIE WOODS,SHARON WOZNY, MARIE WRIGHT,GRACE WRIGHT, KIMBERLY WRIGHT,MALCOLM WRIGHT, PATRICIA WLI,ANITA WU, DONNA YARGIELLO,TADEUSZA YATES,CHRISTINE YEAMAN LINDA YELL,HAYDEE YIP-CHOYSANDY YORKSTON,LYNDA YOUNG,GERALDINE YOUNG,WANDA ZACH,HELEN ZADRAVEC,MARY ZAITZ, FRANCES ZAKRZEWSKI,BRENDA ZAVARELLA,ROSI ZECCA,LYNIN ZELEZNAK KATHY ZELINSKTJOYCE ZEMAITIS,AUDREY ZENGE&PETER ZIGON,HILDA ZIPETO,LINA ZIVOLAK,DENISE zoccol[Lo, ]rrDrTH ZOLDAK RYSZARDA ZCF,I<E\,ELAINE ZRINSCAKMARY ZSIROS, AGATHA ZSIROS, BRENDA ZLILYNIAK,SANDRA ZWICKE&SUZANNE ZYCHOWICZ,BEN YAMASHITA, THOMAS YANKOU, DAWN 154 sT.losEPH Who was St.]oseph?Scripturetells us simply that he was a carpenter,the husband of Mary, and the man ]esus called "Father". His name evokes images of stability, silent strength, loving gentlenessand deep faith. He was a man of vision - a dreamer. It was in dreams that |oseph was invited to open his armsand his heart to Mary and to jesus,to flee with them to Egypt, to lovingly guard and protect themfromall harm.Thuslosephbecamepartof theMission of theSonhesharedwithGod, and part of our salvation history. Josephwas not afraid to follow a dream, to take risks and radically changeeven his best-laid plans. For dreams that are of God inspire and call for action. The Sistersof St.Josephwho establishedSt. joseph's Hospital in Hamilton a hundred years ago also had a dream - to continue the healing mission of Jesusby caring for suffering people with the gentle and loving compassionexemplified by their patron. As St. foseph's Hospital enters its second century, may the "people of St. Joe's" continue courageouslyto follow this dream, to chart new visions, to be creative and responsive to the needsof oui rapidly changing times. lv{ay they be faithful as Josephwas. SisterMary Ambrose,C.S.J. 155 INDEX Illustrations are indicated in boldface A Anderson, Jane 125,131 Ambrose, Sister Mary, 155 Auxiliary, first formed in 19,15,38,5& 119 B Bailey, Peter,T Balfe, Dr. Thomas H, 24, 9'I..,92"99 Ballantyne,Dr. E.N., 39 Barry, SisterUrsula,38 Bergin, SisterVincent, 107 Bester,Sisterlrene, 35 Bomes,Robert and fune, 74,7V79 BowmarL Dr. Fred,31 Bruch, Agnes,39 Bunning, Maria (SisterMartha),8 Burh, SisterAngela,58 c Cameron,Dr. Gordon,63, (5 Campbell, Sister Gerald ine, 42,,!16 Carr, Dr. Meyer,36,42 Carroll, Sister Camilla, 22 Casa Maria, 31, 33, U, 42 Cass,SisterL@,97 Cavicchioli, Gino, Hamilton artist, 15 Chapels,1922-30,1955- 59,7987-lZ3 Chute, Dr. laurie The Hospital for Sick ChildrerUToronto, 58 Cino, Gilda,8l Cleary, SisterBride,22 Collins, Mother Paschal,48 Congregation of the Sistersof St.Joseph, history, 13-15,17 Culliton, SisterSt. fames, 40,49,55 de Charbonnel, Bishop of Toronto, 8 D Dales,SisterSt. Edmund,43 DeCoste,Mrs. Irene, 109-110, Diemert, Rose,95 Dowling, Bishop Thomasfoseph, fourth Bishop of Hamilton, 19,24,30 Dowling, Mrs. A.,24 Downes, Dr. William P., hospital's first intern, 25-26,30,35, 41,!16,91-92"95, 10$104 115 Dubois, Emil, chairman of the Lay Advisory Board,49 Duffn SisterEdward,35, 39,40 Dundurn Castle,11,19 Dymond, Matthew, Ontario health minister,75,80 France,origins of the Sistersof St. foseph, 13 Fraser,h.R.|.,42 Friesen"Gordon A., hospital consultant, 4U9,51-52 G Gainor, SisterLoretto, 103-104,10S Gallagher,SisterMercedes,34, 103 Galloway, Dr. JamesD., 70, 71,72"82, 722121726 Garwood-Jones,Trevor, architect, 85 Gilkes, Mrs. Jeanette,executive director of St.Joseph'sHospital Foundatiory 126 Gilmour, joyce 55-55 Goldbeqg,Dr. William, 63, 65, 68,U Gordon, Father Edward, Vicar General of Hamiltory 8,9-10 Graf, Sister hrbar a, 172 Green,Dr. O.R.,42 Greenwood,Hugh,7 Greve, Allan, executive director, 89 E East wing, t27,733 Edgar,Dr. |ames,27,28,91 Evans,Dr. John R., dean, Faculty of Medicine, McMaster University Medical School,79,82 F Fagan,SisterAnciila, 41 Fagan, Sister Bonaventure, 109 Fairclough, Ellen, PostmasterGeneral, 50 Fartell, Rt. Reverend Johry first Bishop of Hamilton, 11 Fire, May 1, 79n, 179,720,727,!22, Firestone Regional Chest and Allergy unit,7178 Fischer, Sister Cleophas, 5&59 Fischer,SisterRita Paul,38 Flahaven,SisterAntoin elte,22 Flaherty, Sister Marin4 Z 76 Fontbonne,feanne (SisterSt.Iohn), & 13, 75,77 Fontbonne, Sister Delphine, S, 9 Ford, Nehemiah, mayor of Hamiltory 9 Ford, Sister Loretto, 122 H Haggar, Dr. Robert, SA HallmarL Miss Sylvia, first clinical instructor,98 Hamilton GeneralHospital, 20, 92-93 Hanlon, SisterViqginia, 7, 53, 90,96-99, 109-110 Hayes,Mother Alacoqug 50,71-72,75, 83 Hayes,SisterSt. Brigid,35 HendersonHospital,34 Hollinrake, Dt. A., 47,44 Hudecki, Dr. Stan,ffi,65,709 Hudecki, Leona, 1V7,10A709 I Ingham, Dr. Kenneth, 65,77,79, U, 124t2s 156 J |ackson, Mayor Lloyd D., 50 Iaimet, Dr. Charles,57-58,79 JamiesoryDr. William, rt6 Jewell, David, social worker, L24 Johns,Dr. M.,57 Johnson,Dr. A.,65 K Kehoe,SisterAssumpion, 100-101,10& 704 Kemp, Dr. Robert,85 Kortum, Frederick 12 Kraft, Dr. Kafl,44 L Lane,Dr. Alan,66,67 Lardie SisterSt. Paul,49,5Q 55 [aw, John T., The Hospital for Sick Children, Toronto, 6&59 Le Puy, Francg Sisters of St. Joseph history, 14 Lenaten,Jane,(Mother Philip), 17-72,2L22,41, Lepinskie, Miss Mary Rit4 117 Logel, Debbie, T Long, Mother Martina, 91 Lyon, Dr. E. Kirk, chairman of the Canadian Commission on Hospital Accreditatiory 50 M Majeske,Edith,95 Margerum, Sister Alphonsus, 11 Marrin, Mary, 34, 41, 42,709 Marshall, SisterAnn, 46, 47,76, 83, 112 Martin, Sister Leonie,30 Maskell, Mrs. Thelma, director of volunteers, 120-722 Matthews,Lorna,70 Maxims, Sistersof St. foseph, philosophy,74 McBridg Sister Antoinette, 35 McClarty, Sister St. Basil,30-31,35, 99, 704 McCreary, Dr. Iack, The Hospital for Sick Children, Toronto, 70 McDonnell, SisterJoseph,8 McGinnis, Sister Marcelline, 22 McHarg Dr. Robert, 110 McKenna, Sister Eileen,rM, 52 Mc[.ean, Mrs. Constance, director of volunteers, 119 McMaster University, 57 -58,7832, 722 McNab, Sir Allan, 11 McNab, Sophia, 11 Medaille, |ean Pierre, Jesuit priest and spiritual director of the Congregation of the Sistersof St.Joseph,13-14,77 Meegan,Sister Alphonsa, 35 Miller, Franlg premier of Ontario, S4 Mitchell, Dr. Donna, 125 Mohawk College, 82, 111,115 Mooney, Sister Norine, 56 Morary SisterGerard, 97, 704 Morelli, Phyllis, T0 Motherhouse,the Sisters'convent,9 Moulinier, Reverend Charles,SJ., founder of the Catholic Hospital Association of the United Statesand Canada,2&29 Mount St.Ios€ptt orphanage,17 Mulholland, Mary, 130 Murray, Dr. Kennettr, 41 Murray, Miss lrene, 99-1N, tOz N Nace,Dr. P.,57 Nephrology, Regional Dalysis Unit, 7& 81 Newhouse,Dr.Michael,76,77 Nurses'residences:Undermount,93,94, Marygrove,9g Oakbank,99, Fontbonne,111,118 o C/Brien, Dr. S.E.(Ted),65{5, C/Brien, Frances,107 OrDwyer, Sister Lioba, 3G37 C/Hagan, SisterVincent, 12 O/Neill, Sister Kathleen,124, lT), 137 C/Sullivan, Father SeanP.,115 C/Sullivan, SisterJoan,7, 58,84,112, 715,727-122,124,13s Obermeyer,Mrs. Margaret, 110-111,113 Olmsted, Dr. Ingersol, 24,9'1.,99, 103-104 Osbaldeston,Dr. Jim, 65-56,68,77, 75, 83,115 P Parry, Dr. J.R.,35 Paterson,Joan,7,61 Pautler, SisterMary Rosr',42,45,51-52 Peart,Miss Margaret L.,177 Pigott Construction,32"39, 49,55,f36 Pigott, foseph, 35, 48,49, 55,67 Pigott, foseph, lr., 49 Playfair, D.. Iatry L.,96,703 Prack, AlvirU Prack and Prack, Architects,49,50 a Quigley, Dr. Gerard J., 24,34,43,44 R Reding,Bishop Paul, 76, 175 Reding, SisterMary Austin,43, 61 Reid, Mr. E.K., pharmacist,32 Rice,Mr. T.A., president of the Hamilton Health Associatiory72,8445 Riordan, SisterEvelyn, tl4, Robarts,Premier|ohn,49,50 Rosebrugh,Dr.W., performed first operation at St.]oseph's,23 Ryan, Bishop JosephF., 35, 38, 41,46,68, 70,7s,771 Ryan, Father ] eremiah, 12, 22 Ryan, Sister Mary |ane, 81 s Schaefur,SisterM. Victor,42 Schmidt,SisterAudry, 39,49 Schnarr, Sister Gerald (Beatrice),52 Scott,Donald,720-727 Scully, William, chairman of first fundraising campaign,48, 50,83 Sheridan,Annie (SisterPhilomene),11 Shimizu, Dr. Arthur,80 Simpso+ Ieanette, 104-105 Smiley, Robert, publisher, The Hamilton Spectator,9 Smitb Dr. E. KinseyM.,79{1 SmitlUMrs. Floss,10G104,101 Smythe,SisterMonica, 10t 107-108,118 Sourbier, Sister Herman, 22 '1.89,4,23,24,30 St. Ann:s Wing, built in St. Denis,SisterSylvia,3S St. |oseph's Community Health Centre, u&,87,88 St.foseph'sfthool of Nursing and Nursing Service,directors, 118 St.Iosepb 26,155 St. Ma4/s Church,9, 12 St. Ma4/s Orphanage,12 St. Ma4/s School,11 St. Patrick'sSchool,11 Stevens,SisterMary Grace,4749, 52, 56, 57,8, 6146, 77, 75, U,'1,05,1.09,126 Stuart,Dr. C.K.,41 Sullivan, Dr. Herbert, |r., 26-27,34,N47,U,M,9 Sullivan, Dr. Herbert, Sr., 25-28,26, 30, 35,ffi,91.,100,103 Sullivary SisterNancy, 130 Szabo,Sister Mildred, 37-38 157 T Thode Dr.H,57,79 Tilden, Dr. fohn, 107 TomlinsorL Dr. R.,58 Tonnos, Most ReverendA.F., Bishop of Hamilton,6 Toronto, the Sisters set out from, $ 10 Tuckett, George E., presented an electric elevator to hospital, 24 U Undermount, the original hospital, 19, bill of sale 20 Unsworth, Dr. Aler',27 v Vanier, Governor GeneralGeorgesP.,47 Vincec, Sister Stephanie,7 Volunteers, 179-120,722 w Walker, Dr. Iack, 65 Walker, SisterAloysius, 8 Walsh, Dr. Bill,55 Weadick, Sister Mary Daniel, 53, 67, 723 Weber,Jamie,72, 73, 7177 West wing, 128,L33 White, Dr., first chairman of attending staff of physicians,23 Wiggins, Sister Mary David, 110 Williams, Dorothy, 105,106.,1,07 Williams, Dr. KennethJ.,63-72,64 Woodhall, Dr. Frank, 26, 35,M, 46,104 Wright, Mrs. Pat, 117-112,174,775